Provider Demographics
NPI:1275410789
Name:DEJANO, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:DEJANO
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 1:16656 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-5340
Mailing Address - Country:US
Mailing Address - Phone:402-578-9861
Mailing Address - Fax:
Practice Address - Street 1:16155 BRIAR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-1194
Practice Address - Country:US
Practice Address - Phone:402-578-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care