Provider Demographics
NPI:1184303158
Name:ASADIFAR, SARA (LMFT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ASADIFAR
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 1:2 ANDALUZ
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-6061
Mailing Address - Country:US
Mailing Address - Phone:949-322-1445
Mailing Address - Fax:
Practice Address - Street 1:3700 CAMPUS DR STE 206
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2604
Practice Address - Country:US
Practice Address - Phone:657-464-3573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138595106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist