Provider Demographics
NPI:1720104094
Name:TIENDA, SARA SANJUANA LUCIA (MSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:SANJUANA LUCIA
Last Name:TIENDA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S CITRON ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4421
Mailing Address - Country:US
Mailing Address - Phone:714-758-7030
Mailing Address - Fax:
Practice Address - Street 1:12714 AVALON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-2730
Practice Address - Country:US
Practice Address - Phone:323-242-5000
Practice Address - Fax:323-242-5011
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker