Provider Demographics
NPI:1083078760
Name:SARA RECTOR
Entity Type:Organization
Organization Name:SARA RECTOR
Other - Org Name:CIRCLE OF LIFE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT
Authorized Official - Phone:805-750-4545
Mailing Address - Street 1:501 MARIN ST
Mailing Address - Street 2:202
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4260
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 MARIN ST
Practice Address - Street 2:202
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4260
Practice Address - Country:US
Practice Address - Phone:805-494-1414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24825103TC0700X
CAMFC19302106H00000X
CAMFC31230106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1871957944OtherNPI
CA1578784146OtherNPI
CA1962650242OtherNPI