Provider Demographics
NPI:1134243199
Name:MITCHELL, SARAH A (MFT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:HIRSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 614
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93062-0614
Mailing Address - Country:US
Mailing Address - Phone:818-901-4830
Mailing Address - Fax:
Practice Address - Street 1:6842 VAN NUYS BLVD
Practice Address - Street 2:6TH FLOOR
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4650
Practice Address - Country:US
Practice Address - Phone:818-901-4830
Practice Address - Fax:818-373-4830
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2013-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist