Provider Demographics
NPI:1366707762
Name:PLATT, SARA MELISSA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MELISSA
Last Name:PLATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5719 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5048
Mailing Address - Country:US
Mailing Address - Phone:323-449-5655
Mailing Address - Fax:
Practice Address - Street 1:5719 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5048
Practice Address - Country:US
Practice Address - Phone:323-449-5655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist