Provider Demographics
NPI:1912315052
Name:HIRAD, SARA (PSYD, LMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HIRAD
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2498
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-1798
Mailing Address - Country:US
Mailing Address - Phone:858-367-0525
Mailing Address - Fax:
Practice Address - Street 1:9666 BUSINESSPARK AVE STE 207
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1646
Practice Address - Country:US
Practice Address - Phone:858-367-0525
Practice Address - Fax:858-367-8383
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80882106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist