Provider Demographics
NPI:1699652404
Name:KAUFFMAN, SARAH LARUE (ACSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LARUE
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E CHESTNUT AVE APT J
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-5977
Mailing Address - Country:US
Mailing Address - Phone:307-438-6207
Mailing Address - Fax:
Practice Address - Street 1:12431 LEWIS ST STE 102
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4653
Practice Address - Country:US
Practice Address - Phone:307-438-6207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker