Provider Demographics
NPI:1235678244
Name:KO, SARAH HYAERAN (LMFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:HYAERAN
Last Name:KO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1843
Mailing Address - Country:US
Mailing Address - Phone:818-903-2015
Mailing Address - Fax:
Practice Address - Street 1:3727 W 6TH ST
Practice Address - Street 2:411
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5105
Practice Address - Country:US
Practice Address - Phone:213-365-7400
Practice Address - Fax:213-201-3993
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT109353106H00000X
172V00000X
CALMFT141825106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker