Provider Demographics
NPI:1922761899
Name:NELSON, SARAH JEAN (LMFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:NELSON
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 1:3648 PENNSYLVANIA PL
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1969
Mailing Address - Country:US
Mailing Address - Phone:626-327-6208
Mailing Address - Fax:
Practice Address - Street 1:1425 W FOOTHILL BLVD STE 300
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3689
Practice Address - Country:US
Practice Address - Phone:909-303-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140772106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist