Provider Demographics
NPI:1093820276
Name:BREDING, SARAH MERCHANT (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MERCHANT
Last Name:BREDING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 PASSIFLORA AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2215
Mailing Address - Country:US
Mailing Address - Phone:760-505-0588
Mailing Address - Fax:
Practice Address - Street 1:125 W MISSION AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1720
Practice Address - Country:US
Practice Address - Phone:760-747-3424
Practice Address - Fax:760-747-3435
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS151351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACSW151350Medicaid
CACSW151350Medicaid