Basic Information
| Provider Information | |||||||||
| NPI: | 1780725507 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RANDALL | ||||||||
| FirstName: | SARAH | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23622 CALABASAS RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | CALABASAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913021549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189214300 | ||||||||
| FaxNumber: | 8779173450 | ||||||||
| Practice Location | |||||||||
| Address1: | 23622 CALABASAS RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | CALABASAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913021549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189214300 | ||||||||
| FaxNumber: | 8779173450 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 02/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 103TC0700X | 26016 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.