Provider Demographics
NPI:1477791820
Name:SADLER, ELISABETH SAKURA (MA, MFT MFC46436)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:SAKURA
Last Name:SADLER
Suffix:
Gender:F
Credentials:MA, MFT MFC46436
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12520 MAGNOLIA BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2336
Mailing Address - Country:US
Mailing Address - Phone:818-231-0707
Mailing Address - Fax:818-760-7685
Practice Address - Street 1:12520 MAGNOLIA BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-2336
Practice Address - Country:US
Practice Address - Phone:818-231-0707
Practice Address - Fax:818-760-7685
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46436106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist