Healthcare Provider Details

I. General information

NPI: 1326367756
Provider Name (Legal Business Name): SARAH MIORANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2010
Last Update Date: 12/30/2019
Certification Date: 12/30/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20094 MISSION BLVD
HAYWARD CA
94541-1237
US

IV. Provider business mailing address

991 43RD ST
OAKLAND CA
94608-3715
US

V. Phone/Fax

Practice location:
  • Phone: 510-727-9755
  • Fax:
Mailing address:
  • Phone: 510-332-7281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number240408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: