Provider Demographics
NPI:1477621043
Name:LEON, SARAH JUDY (MFT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JUDY
Last Name:LEON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6470 LEWIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422
Mailing Address - Country:US
Mailing Address - Phone:805-440-4776
Mailing Address - Fax:805-925-3041
Practice Address - Street 1:6470 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422
Practice Address - Country:US
Practice Address - Phone:805-440-4776
Practice Address - Fax:805-925-3041
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC-31195106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist