Provider Demographics
NPI:1265874523
Name:NICELY, SARAH (LMFT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NICELY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:VALENZUELA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:10722 ARROW RTE
Mailing Address - Street 2:SUITE #314
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4808
Mailing Address - Country:US
Mailing Address - Phone:909-484-8888
Mailing Address - Fax:909-581-0920
Practice Address - Street 1:10722 ARROW RTE
Practice Address - Street 2:SUITE #314
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4808
Practice Address - Country:US
Practice Address - Phone:909-484-8888
Practice Address - Fax:909-581-0920
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CALMFT90888106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health