Provider Demographics
NPI:1245616580
Name:BARATI, SAGAR
Entity Type:Individual
Prefix:
First Name:SAGAR
Middle Name:
Last Name:BARATI
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 1:30916 GRANGER AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-1621
Mailing Address - Country:US
Mailing Address - Phone:702-280-3619
Mailing Address - Fax:
Practice Address - Street 1:30916 GRANGER AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1621
Practice Address - Country:US
Practice Address - Phone:702-280-3619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2022-07-11
Deactivation Date:2019-05-14
Deactivation Code:
Reactivation Date:2022-07-11
Provider Licenses
StateLicense IDTaxonomies
CAASW676781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical