Provider Demographics
NPI:1285720953
Name:GAYL, SARA LEGEMAN (MS, MFT)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LEGEMAN
Last Name:GAYL
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 PARSONS LNDG
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-6814
Mailing Address - Country:US
Mailing Address - Phone:562-494-9711
Mailing Address - Fax:714-893-3267
Practice Address - Street 1:110 W OCEAN BLVD
Practice Address - Street 2:SUITE 18
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4605
Practice Address - Country:US
Practice Address - Phone:714-898-0362
Practice Address - Fax:714-893-3267
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 32609101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor