Provider Demographics
NPI:1740328111
Name:SIMPSON, SARA LEDERER (PSYD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LEDERER
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5961 NORA LYNN DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-1056
Mailing Address - Country:US
Mailing Address - Phone:310-663-6736
Mailing Address - Fax:
Practice Address - Street 1:5961 NORA LYNN DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-1056
Practice Address - Country:US
Practice Address - Phone:310-663-6736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23416103TC0700X
390200000X
CAPSY25416103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program