Provider Demographics
NPI:1871101410
Name:SAENZ, SARAH ELOISE (BS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELOISE
Last Name:SAENZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 CANBY AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-2979
Mailing Address - Country:US
Mailing Address - Phone:818-921-3466
Mailing Address - Fax:
Practice Address - Street 1:7601 CANBY AVE STE 3
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-2979
Practice Address - Country:US
Practice Address - Phone:818-921-3466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
172V00000X
CAACSW123445104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker