Provider Demographics
NPI:1881724128
Name:PARK, SARAH F (LPCC6546)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:F
Last Name:PARK
Suffix:
Gender:F
Credentials:LPCC6546
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5249
Mailing Address - Country:US
Mailing Address - Phone:530-748-9554
Mailing Address - Fax:
Practice Address - Street 1:991 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5249
Practice Address - Country:US
Practice Address - Phone:530-748-9554
Practice Address - Fax:530-748-9554
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC6546101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health