Provider Demographics
NPI:1033508767
Name:HOWARD, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HOWARD
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 1:1475 S BASCOM AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0624
Mailing Address - Country:US
Mailing Address - Phone:408-614-2180
Mailing Address - Fax:
Practice Address - Street 1:1475 S BASCOM AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0624
Practice Address - Country:US
Practice Address - Phone:408-614-2180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-10446103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst