Provider Demographics
NPI:1033753587
Name:WILLIAR, SARAH MARIE (LPCC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:WILLIAR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 WILD OATS LN
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902-3047
Mailing Address - Country:US
Mailing Address - Phone:619-240-5399
Mailing Address - Fax:
Practice Address - Street 1:4679B INCHON ST
Practice Address - Street 2:
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310-1950
Practice Address - Country:US
Practice Address - Phone:619-240-5399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC4550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional