Individual provider Active NPI

Sara Judith Ullom, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1154664795
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
101848 Issued in CA
Practice address
10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724
Phone
(858) 279-1223
NPI assigned
Apr 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 101848 CA Primary

Addresses

Primary practice location

10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724

Mailing address

10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724

Other names 1

  • Sara Ullom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829000000 CA Practitioner - Marriage and Family Therapist 7911446364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

10815 Rancho Bernardo Rd
Suite 380
San Diego, CA 92127-5724
Phone (858) 279-1223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101848CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Sep 1, 2024 Accepting new patients
Wellmind Online Ca Licensed Clinical Social Worker Prof Corp Past Accepting new patients

Locations

8881 Fletcher Pkwy
Ste 350
La Mesa, CA 91942
Phone (619) 465-9792

10815 Rancho Bernardo Rd
Ste 380
San Diego, CA 92127

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1154664795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10815 RANCHO BERNARDO RD STE 380",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 RANCHO BERNARDO RD STE 380",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275724",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOM",
        "first_name": "SARA",
        "middle_name": "JUDITH",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-02",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "ULLOM",
            "credential": "SARA ULLOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.