Provider Demographics
NPI:1013198928
Name:SAHACHARTSIRI, RANEE TAECHAMEENA (LCSW)
Entity Type:Individual
Prefix:
First Name:RANEE
Middle Name:TAECHAMEENA
Last Name:SAHACHARTSIRI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1814
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92581-1814
Mailing Address - Country:US
Mailing Address - Phone:951-732-8377
Mailing Address - Fax:
Practice Address - Street 1:8876 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:JURUPA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92509-2811
Practice Address - Country:US
Practice Address - Phone:951-955-0507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA701371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health