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General NPI Number Information
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NPI Number | 1073060547
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Entity Type | Organization
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Legal Business Name | SIERRA ENV & SOCIAL SERVICES INC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 3645 LORENA AVE E
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-4369
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Country | US
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Telephone | 510-205-1448
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Fax |
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Provider Business Mailing Address
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Address Line | 3645 LORENA AVE SUITE E
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City | CASTRO VALLEY
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State | CA
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Zip | 94546
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Country | US
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Telephone | 510-205-1448
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Fax | 510-582-4969
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Authorized Official
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Title or Position | ADMINSTRATIVE DIRECTOR
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Name | AJATI SANKOH
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Credential |
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Telephone | 510-205-1448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number | 400016929
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License Number State | CA
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