Provider Demographics
NPI:1386146959
Name:SEARGEANT, ANDREW (AMFT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SEARGEANT
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 JOANN ST
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-6455
Mailing Address - Country:US
Mailing Address - Phone:949-375-6273
Mailing Address - Fax:
Practice Address - Street 1:250 JOANN ST
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-6455
Practice Address - Country:US
Practice Address - Phone:949-375-6273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100440101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100400OtherASSOCIATE MARRIAGE & FAMILY THERAPIST