MEDICARE: RACHENA SAR

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1811669245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHENA SAR

Provider Business Mailing Address
First Line	:	16782 VON KARMAN AVE STE 11
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92606-2417
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:

Provider Business Practice Location Address
First Line	:	2863 ANDERSON AVE
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96818-6209
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2021
Last Update Date	:	10/04/2021

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Directions to “ RACHENA SAR ” Practice Location

Language	Start Address	Practice Location

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