Healthcare Provider Details

I. General information

NPI: 1528990793
Provider Name (Legal Business Name): SARAH JANE BANARES BALLERDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH JANE BALLERDA

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 7TH ST
SAN FRANCISCO CA
94103-4029
US

IV. Provider business mailing address

1056 GRAND AVE APT 204
SOUTH SAN FRANCISCO CA
94080-7214
US

V. Phone/Fax

Practice location:
  • Phone: 415-615-8441
  • Fax:
Mailing address:
  • Phone: 925-839-6142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number20572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: