Healthcare Provider Details

I. General information

NPI: 1124944889
Provider Name (Legal Business Name): SARAH PAYNE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 I ST STE 2
LOS BANOS CA
93635-4125
US

IV. Provider business mailing address

203 LIME AVE
LOS BANOS CA
93635-3147
US

V. Phone/Fax

Practice location:
  • Phone: 209-214-4575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SARAH NICOLE PAYNE
Title or Position: THERAPIST
Credential: LCSW
Phone: 209-214-4575