Provider Demographics
NPI:1154664795
Name:ULLOM, SARA JUDITH (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JUDITH
Last Name:ULLOM
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:ULLOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SARA ULLOM
Mailing Address - Street 1:10815 RANCHO BERNARDO RD STE 380
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10815 RANCHO BERNARDO RD STE 380
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-5724
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist