Provider Demographics
NPI:1679261721
Name:LEVERENCE, SARAH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LEVERENCE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 PENINSULA RD APT 165
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-4016
Mailing Address - Country:US
Mailing Address - Phone:262-804-2200
Mailing Address - Fax:
Practice Address - Street 1:1901 N RICE AVE STE 170-180
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7912
Practice Address - Country:US
Practice Address - Phone:805-826-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27671235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist