Provider Demographics
NPI:1326470725
Name:BERHANE, SARAH RUTH (LVN)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:RUTH
Last Name:BERHANE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 S RENO ST APT 326
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1187
Mailing Address - Country:US
Mailing Address - Phone:408-528-5200
Mailing Address - Fax:
Practice Address - Street 1:307 S RENO ST APT 326
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1187
Practice Address - Country:US
Practice Address - Phone:408-528-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255951164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse