Provider Demographics
NPI:1073060547
Name:SIERRA ENV & SOCIAL SERVICES INC
Entity Type:Organization
Organization Name:SIERRA ENV & SOCIAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AJATI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANKOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-205-1448
Mailing Address - Street 1:3645 LORENA AVE SUITE
Mailing Address - Street 2:E
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546
Mailing Address - Country:US
Mailing Address - Phone:510-205-1448
Mailing Address - Fax:510-582-4969
Practice Address - Street 1:3645 LORENA AVE
Practice Address - Street 2:E
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4369
Practice Address - Country:US
Practice Address - Phone:510-205-1448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA400016929347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus