Provider Demographics
NPI:1598327280
Name:VELA, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:VELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6194 BRYNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-5846
Mailing Address - Country:US
Mailing Address - Phone:805-300-7910
Mailing Address - Fax:
Practice Address - Street 1:6194 BRYNDALE AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-5846
Practice Address - Country:US
Practice Address - Phone:805-300-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator