Provider Demographics
NPI:1487384418
Name:MILLWEE-WELCH, SARAH (PHD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MILLWEE-WELCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 CALIFORNIA CT
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-5302
Mailing Address - Country:US
Mailing Address - Phone:949-616-9848
Mailing Address - Fax:
Practice Address - Street 1:16162 BEACH BLVD STE 308
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3894
Practice Address - Country:US
Practice Address - Phone:949-616-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY33413103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical