Healthcare Provider Details

I. General information

NPI: 1144505371
Provider Name (Legal Business Name): MISS SARA NOEMI PIZANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15305 RAYEN ST
NORTH HILLS CA
91343-5117
US

IV. Provider business mailing address

15305 RAYEN ST
NORTH HILLS CA
91343
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-3384
  • Fax: 818-895-5186
Mailing address:
  • Phone: 818-894-3384
  • Fax: 818-895-5186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: