Provider Demographics
NPI:1386018729
Name:HAYNES, SARA SEDLIK (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SEDLIK
Last Name:HAYNES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:SEDLIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2100 N SEPULVEDA BLVD STE 23
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2957
Mailing Address - Country:US
Mailing Address - Phone:310-584-7789
Mailing Address - Fax:
Practice Address - Street 1:2100 N SEPULVEDA BLVD STE 23
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2957
Practice Address - Country:US
Practice Address - Phone:310-584-7789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90478106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist