Provider Demographics
NPI:1518747674
Name:MORENO, SARAI (SLP)
Entity type:Individual
Prefix:
First Name:SARAI
Middle Name:
Last Name:MORENO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2446 PINON SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4497
Mailing Address - Country:US
Mailing Address - Phone:661-800-1894
Mailing Address - Fax:
Practice Address - Street 1:2446 PINON SPRINGS CIR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4497
Practice Address - Country:US
Practice Address - Phone:661-800-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist