Provider Demographics
NPI:1932235140
Name:GRECO, SARAH ALISON (LMFT 82932)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ALISON
Last Name:GRECO
Suffix:
Gender:F
Credentials:LMFT 82932
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:KOENIGSBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5332 REPECHO DR APT 104
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-1719
Mailing Address - Country:US
Mailing Address - Phone:619-663-9877
Mailing Address - Fax:
Practice Address - Street 1:3344 4TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5704
Practice Address - Country:US
Practice Address - Phone:619-663-9877
Practice Address - Fax:844-793-8254
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82932106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty