Provider Demographics
NPI:1659898112
Name:MOHAMED, SARA AWAD
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:AWAD
Last Name:MOHAMED
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 1:6703 BARNARD LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-7748
Mailing Address - Country:US
Mailing Address - Phone:909-800-4016
Mailing Address - Fax:
Practice Address - Street 1:6703 BARNARD LN
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-7748
Practice Address - Country:US
Practice Address - Phone:909-800-4016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst