Sara Granovetter, LMFT, PHD
Individual provider Active NPI Counselor · Fairfax, CA
NPI 1043904402 · NPPES record last updated Jun 7, 2023
Key facts
- NPI
- 1043904402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 116255 (CA)
- Practice address
- 93 Wood LN
Fairfax, CA 94930-2015 - Phone
- (415) 992-1470
- NPI assigned
- Jun 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116255 | CA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 116255 | CA | Yes |
Addresses
Primary practice location
93 Wood LN
Fairfax, CA 94930-2015
Mailing address
879 Mayfield Ave
Stanford, CA 94305-1052
Phone (415) 992-1470
Other providers in Fairfax, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.