Provider Demographics
NPI:1366536021
Name:BENNETT, SARAH ELIZABETH (MA, MFTI)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CALLE VAQUETA
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-1252
Mailing Address - Country:US
Mailing Address - Phone:949-892-9151
Mailing Address - Fax:
Practice Address - Street 1:5 CALLE VAQUETA
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-1252
Practice Address - Country:US
Practice Address - Phone:949-892-9151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48093101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health