Provider Demographics
NPI:1134569130
Name:WEIL, SARAH M (MSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:WEIL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MINDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 8178
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91327-8178
Mailing Address - Country:US
Mailing Address - Phone:310-490-9556
Mailing Address - Fax:
Practice Address - Street 1:16111 PLUMMER ST
Practice Address - Street 2:
Practice Address - City:SEPULVEDA
Practice Address - State:CA
Practice Address - Zip Code:91343-2036
Practice Address - Country:US
Practice Address - Phone:818-891-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11181171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator