Provider Demographics
NPI:1427179290
Name:SERRANO, SANDRA (RAS)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:SERRANO
Suffix:
Gender:F
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 W BEAMER ST
Mailing Address - Street 2:14 N. COTTONWOOD STREET
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-2663
Mailing Address - Country:US
Mailing Address - Phone:530-666-8658
Mailing Address - Fax:530-666-8663
Practice Address - Street 1:178 W BEAMER ST
Practice Address - Street 2:14 N. COTTONWOOD STREET
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2663
Practice Address - Country:US
Practice Address - Phone:530-666-8658
Practice Address - Fax:530-666-8663
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS0502181644101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor