Provider Demographics
NPI:1407255920
Name:VAZQUEZ, SARAI EVA (BA)
Entity Type:Individual
Prefix:
First Name:SARAI
Middle Name:EVA
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 FAIR OAKS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-2694
Mailing Address - Country:US
Mailing Address - Phone:323-341-5580
Mailing Address - Fax:
Practice Address - Street 1:625 FAIR OAKS AVE STE 200
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2694
Practice Address - Country:US
Practice Address - Phone:323-341-5580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst