Provider Demographics
NPI:1063090918
Name:LUNN, SARAH GOODMAN
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:GOODMAN
Last Name:LUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 BORDER AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1410
Mailing Address - Country:US
Mailing Address - Phone:310-408-5990
Mailing Address - Fax:
Practice Address - Street 1:19750 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1119
Practice Address - Country:US
Practice Address - Phone:714-781-9934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst