Provider Demographics
NPI:1013102300
Name:KAMDAR, SARAH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:KAMDAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:FOROOSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:15332 ANTIOCH ST
Mailing Address - Street 2:# 519
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3628
Mailing Address - Country:US
Mailing Address - Phone:310-571-8160
Mailing Address - Fax:
Practice Address - Street 1:1452 26TH ST
Practice Address - Street 2:STE 102
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3042
Practice Address - Country:US
Practice Address - Phone:310-571-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CAPSY30622103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor