Provider Demographics
NPI:1013564780
Name:BAYAA, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BAYAA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 ORANGE BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1251
Mailing Address - Country:US
Mailing Address - Phone:949-282-9006
Mailing Address - Fax:
Practice Address - Street 1:391 JENKS DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-2518
Practice Address - Country:US
Practice Address - Phone:949-922-5988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician