Provider Demographics
NPI:1184232092
Name:HULTQUIST, SARAH (LMFT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HULTQUIST
Suffix:
Gender:X
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26791 ALISO CREEK RD # 1080
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2887
Mailing Address - Country:US
Mailing Address - Phone:949-232-3359
Mailing Address - Fax:
Practice Address - Street 1:26791 ALISO CREEK RD # 1080
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2887
Practice Address - Country:US
Practice Address - Phone:949-232-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health