Provider Demographics
NPI:1285198127
Name:CHAUDHRI, SARA (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:CHAUDHRI
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 RINGDAHL CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-6621
Mailing Address - Country:US
Mailing Address - Phone:949-229-3115
Mailing Address - Fax:
Practice Address - Street 1:1411 RIMPAU AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-2693
Practice Address - Country:US
Practice Address - Phone:562-505-2607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA873911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty