Healthcare Provider Details

I. General information

NPI: 1407558927
Provider Name (Legal Business Name): SARA PRECIADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MCHENRY VILLAGE WAY STE 11B
MODESTO CA
95350-4341
US

IV. Provider business mailing address

1700 MCHENRY VILLAGE WAY STE 11B
MODESTO CA
95350-4341
US

V. Phone/Fax

Practice location:
  • Phone: 209-550-5865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: