Provider Demographics
NPI:1134908346
Name:MCADAMS, SARAH REGINA MARIE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:REGINA MARIE
Last Name:MCADAMS
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 1:2158 ARDENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3964
Mailing Address - Country:US
Mailing Address - Phone:530-208-7451
Mailing Address - Fax:
Practice Address - Street 1:2158 ARDENWOOD AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3964
Practice Address - Country:US
Practice Address - Phone:530-208-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA484-278-1648374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty