Provider Demographics
NPI:1407171572
Name:WOOD, SARAH (LMFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WOOD
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:PO BOX 3275
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-7275
Mailing Address - Country:US
Mailing Address - Phone:626-275-8935
Mailing Address - Fax:
Practice Address - Street 1:250 W 1ST ST STE 214
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4743
Practice Address - Country:US
Practice Address - Phone:626-275-8935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87391106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist