Provider Demographics
NPI:1811363781
Name:LEGGETT, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4058 BOB LN
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7312
Mailing Address - Country:US
Mailing Address - Phone:916-612-7076
Mailing Address - Fax:
Practice Address - Street 1:4058 BOB LN
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7312
Practice Address - Country:US
Practice Address - Phone:916-612-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist