Sara Cummo
Individual provider Active NPI Marriage & Family Therapist · Foothill Ranch, CA
NPI 1669918777 · NPPES record last updated Apr 1, 2022
Key facts
- NPI
- 1669918777
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 129703 (CA)
- Practice address
- 27472 Portola Pkwy # 205-127
Foothill Ranch, CA 92610-2853 - Phone
- (714) 404-8877
- NPI assigned
- Jan 12, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF88511 | CA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMF88511 | CA | |
| Marriage & Family Therapist | 106H00000X | 129703 | CA | Yes |
Addresses
Primary practice location
27472 Portola Pkwy # 205-127
Foothill Ranch, CA 92610-2853
Mailing address
27472 Portola Pkwy # 205-127
Foothill Ranch, CA 92610-2853
Phone (714) 404-8877
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- Amy Cole
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- Hootan M Daneshmand
- Huy Dang
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All providers in Foothill Ranch, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2022. 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.