Provider Demographics
NPI:1740599729
Name:CABEZAS-PRENDERGAST, SARA MARIE (MS, PPS, LMFT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:CABEZAS-PRENDERGAST
Suffix:
Gender:F
Credentials:MS, PPS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 SALVIO ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2599
Mailing Address - Country:US
Mailing Address - Phone:925-338-7281
Mailing Address - Fax:925-338-7281
Practice Address - Street 1:2730 SALVIO ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2599
Practice Address - Country:US
Practice Address - Phone:925-687-0374
Practice Address - Fax:925-687-2695
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TS0200X
CALMFT109586106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool