Provider Demographics
NPI:1861547366
Name:SAUERBRUN, RAYA (MA MFT)
Entity type:Individual
Prefix:MRS
First Name:RAYA
Middle Name:
Last Name:SAUERBRUN
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10040 YOLANDA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1538
Mailing Address - Country:US
Mailing Address - Phone:818-349-1045
Mailing Address - Fax:818-361-7727
Practice Address - Street 1:11273 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4300
Practice Address - Country:US
Practice Address - Phone:818-349-1045
Practice Address - Fax:818-361-7727
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 31396101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health