Provider Demographics
NPI:1902248214
Name:RAY, SARA M (ASW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:MRS
Other - First Name:SARA
Other - Middle Name:MAYRIE
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 274
Mailing Address - Street 2:
Mailing Address - City:SANTA RITA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:93661-0274
Mailing Address - Country:US
Mailing Address - Phone:209-743-6322
Mailing Address - Fax:
Practice Address - Street 1:1113 HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249
Practice Address - Country:US
Practice Address - Phone:209-755-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-28
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program