Provider Demographics
NPI:1700388451
Name:AVRATIN, SARA T (LMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:T
Last Name:AVRATIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 W SAN JOSE AVE APT 17
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-5410
Mailing Address - Country:US
Mailing Address - Phone:909-964-4683
Mailing Address - Fax:
Practice Address - Street 1:1539 W GARVEY AVE N
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2139
Practice Address - Country:US
Practice Address - Phone:626-960-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124342106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist