Provider Demographics
NPI:1003945510
Name:CRITELLI, SARAH ANN (MFT)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ANN
Last Name:CRITELLI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-2675
Mailing Address - Country:US
Mailing Address - Phone:310-560-0202
Mailing Address - Fax:
Practice Address - Street 1:517 VERNON AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-2675
Practice Address - Country:US
Practice Address - Phone:310-560-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41906106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist