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NPI Code Detail

MEDICARE: DALIA SEDRAK

MEDICARE: DALIA SEDRAK
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
1103TS0200XSchool Psychologist
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1770180556
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALIA SEDRAK
Provider Business Mailing Address
First Line : 7165 BURTON AVE
Second Line :
City : ROHNERT PARK
State : CA
Zip : 94928-3316
Country : US
Telephone Number : 818-802-2169
Fax Number :
Provider Business Practice Location Address
First Line : 7165 BURTON AVE
Second Line :
City : ROHNERT PARK
State : CA
Zip : 94928-3316
Country : US
Telephone Number : 818-802-2169
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2020
Last Update Date : 01/15/2025

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Directions to “ DALIA SEDRAK ” Practice Location

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