Healthcare Provider Details
I. General information
NPI: 1285436733
Provider Name (Legal Business Name): AGNES SAGAYA RANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/26/2025
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12437 LEWIS ST STE 100
GARDEN GROVE CA
92840-4651
US
IV. Provider business mailing address
12437 LEWIS ST STE 100
GARDEN GROVE CA
92840-4651
US
V. Phone/Fax
- Phone: 209-662-8858
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: