Provider Demographics
NPI:1073010542
Name:SPEERS, SARAH (AMFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SPEERS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3922 MOUNT ACADIA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2614
Mailing Address - Country:US
Mailing Address - Phone:845-380-6526
Mailing Address - Fax:
Practice Address - Street 1:2100 COSTA DEL MAR RD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-6823
Practice Address - Country:US
Practice Address - Phone:845-380-6526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94821106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist