Provider Demographics
NPI:1558023879
Name:SARMIENTO-CARRASCO, ROBERTO CARLOS (BA)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:CARLOS
Last Name:SARMIENTO-CARRASCO
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 WILLIAMS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2665
Mailing Address - Country:US
Mailing Address - Phone:805-981-4200
Mailing Address - Fax:
Practice Address - Street 1:1055 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2327
Practice Address - Country:US
Practice Address - Phone:818-241-6780
Practice Address - Fax:818-241-6853
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician