Provider Demographics
NPI:1003833906
Name:WARAICH, SARWAT BASHIR (PSYD)
Entity Type:Individual
Prefix:
First Name:SARWAT
Middle Name:BASHIR
Last Name:WARAICH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S STATE COLLEGE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5805
Mailing Address - Country:US
Mailing Address - Phone:626-283-5852
Mailing Address - Fax:626-280-3110
Practice Address - Street 1:135 S STATE COLLEGE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5805
Practice Address - Country:US
Practice Address - Phone:626-283-5852
Practice Address - Fax:626-280-3110
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19573103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWCP19573AMedicare PIN