Provider Demographics
NPI:1174410120
Name:EBERLEIN, SARA (APCC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:EBERLEIN
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 VIA LUCCA APT F407
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-8828
Mailing Address - Country:US
Mailing Address - Phone:208-316-8638
Mailing Address - Fax:
Practice Address - Street 1:30 VIA LUCCA APT F407
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-8828
Practice Address - Country:US
Practice Address - Phone:208-316-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC19038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health