Provider Demographics
NPI:1558856948
Name:ARSENAULT, SARA ANNE
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANNE
Last Name:ARSENAULT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32651 ALTA PINE LN
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-4334
Mailing Address - Country:US
Mailing Address - Phone:949-842-6665
Mailing Address - Fax:
Practice Address - Street 1:1200 N MAIN ST STE 500
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-3632
Practice Address - Country:US
Practice Address - Phone:714-480-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health