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NPI Code Detail

MEDICARE: SARAH ELAINE WILKEY

MEDICARE: SARAH ELAINE WILKEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1467117176
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ELAINE WILKEY
Provider Business Mailing Address
First Line : 5700 LOCHMOOR DR APT 200
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-8434
Country : US
Telephone Number : 951-233-6201
Fax Number :
Provider Business Practice Location Address
First Line : 6876 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-2860
Country : US
Telephone Number : 909-229-4502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2021
Last Update Date : 11/08/2021

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Directions to “ SARAH ELAINE WILKEY ” Practice Location

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