Provider Demographics
NPI:1578029997
Name:MIER, SARA V (MS)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:V
Last Name:MIER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 POINTE DR
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-7637
Mailing Address - Country:US
Mailing Address - Phone:714-356-4311
Mailing Address - Fax:
Practice Address - Street 1:713 W COMMONWEALTH AVE STE C
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1612
Practice Address - Country:US
Practice Address - Phone:714-879-4274
Practice Address - Fax:714-870-2274
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA1-19-36300103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician