Provider Demographics
NPI:1013267806
Name:BARTKY, SARA-JEAN LIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARA-JEAN
Middle Name:LIZABETH
Last Name:BARTKY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 SANTA CLARA AVE #203
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610
Mailing Address - Country:US
Mailing Address - Phone:510-433-0123
Mailing Address - Fax:510-433-0133
Practice Address - Street 1:55 SANTA CLARA AVE #203
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610
Practice Address - Country:US
Practice Address - Phone:510-433-0123
Practice Address - Fax:510-433-0133
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022190-1235Z00000X
CASP21349235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist