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Provider Information for 1356789523


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SARAH GBADEBO LMFT


Sex: Female

NPI: 1356789523
Last Updated: 2025-01-23
Certification Date: 2025-01-23

Details

NameValue
NPI1356789523
Enumeration Date2013-06-11
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 647 BEALL ST
THOUSAND OAKS, CA 91360-5415
United States

Phone: 925-719-3179 | Fax:
 
Primary Practice Address 44444 20TH ST W
LANCASTER, CA 93534-2714
United States

Phone: 661-951-0070 | Fax:
 
Secondary Practice Address(es)

7246 REMMET AVE
CANOGA PARK, CA 91303-1531
United States

Phone: 310-412-0879 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
SOAP URL
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Carequality
Health Information Exchange (HIE) C-CDA Kaiser Permanente 44444 20th St W
Lancaster, CA 93534-2714
United States
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCAHDC70069F
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist CA100803
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)