Healthcare Provider Details

I. General information

NPI: 1417807553
Provider Name (Legal Business Name): SARAH E PORRAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 ATASCADERO RD
MORRO BAY CA
93442-1516
US

IV. Provider business mailing address

235 ATASCADERO RD
MORRO BAY CA
93442-1516
US

V. Phone/Fax

Practice location:
  • Phone: 805-771-1845
  • Fax:
Mailing address:
  • Phone: 805-771-1845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number91AFB46CB4
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-124501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: