Provider Demographics
NPI:1508143645
Name:SAWAIRI, SARA (NP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SAWAIRI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SETSUKO
Other - Middle Name:
Other - Last Name:SAWAIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3576 ARLINGTON AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3984
Mailing Address - Country:US
Mailing Address - Phone:562-644-2089
Mailing Address - Fax:
Practice Address - Street 1:3576 ARLINGTON AVE STE 205
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3984
Practice Address - Country:US
Practice Address - Phone:562-644-2089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21403363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care