Provider Demographics
NPI:1548388093
Name:KREIL-SARKAR, KATHERINE R (ACSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:R
Last Name:KREIL-SARKAR
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:R
Other - Last Name:KREIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACSW
Mailing Address - Street 1:1075 E SANTA CLARA ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-2244
Mailing Address - Country:US
Mailing Address - Phone:408-793-5886
Mailing Address - Fax:408-792-2159
Practice Address - Street 1:1075 E SANTA CLARA ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2244
Practice Address - Country:US
Practice Address - Phone:408-793-5886
Practice Address - Fax:408-792-2159
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020837601041C0700X
CA276811041C0700X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical