Provider Demographics
NPI:1093905309
Name:BARNES, SARAH NICOLE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:NICOLE
Last Name:BARNES
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:PO BOX 4504
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90711-4504
Mailing Address - Country:US
Mailing Address - Phone:562-826-7170
Mailing Address - Fax:
Practice Address - Street 1:19401 S VERMONT AVE STE A200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-4418
Practice Address - Country:US
Practice Address - Phone:310-323-6887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT52450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist