1831584820 NPI number — DR. SARA MANGAT PROFESSIONAL PSYCHOLOGICAL CORP.

Table of content: DR. AMBER HOPE FOREMAN PSYD (NPI 1407625833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831584820 NPI number — DR. SARA MANGAT PROFESSIONAL PSYCHOLOGICAL CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. SARA MANGAT PROFESSIONAL PSYCHOLOGICAL CORP.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831584820
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30101 AGOURA CT
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
AGOURA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91301-4300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-991-5401
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3625 E THOUSAND OAKS BLVD
Provider Second Line Business Practice Location Address:
SUITE 109
Provider Business Practice Location Address City Name:
WESTLAKE VILLAGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91362-3626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-991-5401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MANGAT
Authorized Official First Name:
SARABJIT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
310-991-5401

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY22651 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com