Provider Demographics
NPI:1659519098
Name:RYKOFF, SARA H (MA)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:H
Last Name:RYKOFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 W. OLYMPIC BLVD.
Mailing Address - Street 2:SUITE 255
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064
Mailing Address - Country:US
Mailing Address - Phone:310-478-7876
Mailing Address - Fax:310-395-5024
Practice Address - Street 1:11340 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 255
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1608
Practice Address - Country:US
Practice Address - Phone:310-478-7876
Practice Address - Fax:310-395-5024
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
CAMFT22458106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist