Provider Demographics
NPI:1619208998
Name:BERNSON, SARAH ALISA (BS, MS, MFT)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ALISA
Last Name:BERNSON
Suffix:
Gender:F
Credentials:BS, MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8903 ALDEN DR APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3068
Mailing Address - Country:US
Mailing Address - Phone:818-370-4757
Mailing Address - Fax:
Practice Address - Street 1:864 S ROBERTSON BLVD STE 302
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1629
Practice Address - Country:US
Practice Address - Phone:818-370-4757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46299106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist