Provider Demographics
NPI:1841025814
Name:BERGANTZ, SADEE YASMEEN (RADT I)
Entity type:Individual
Prefix:
First Name:SADEE
Middle Name:YASMEEN
Last Name:BERGANTZ
Suffix:
Gender:F
Credentials:RADT I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 S VERDE VISTA ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-7951
Mailing Address - Country:US
Mailing Address - Phone:559-991-8345
Mailing Address - Fax:
Practice Address - Street 1:3724 S VERDE VISTA ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7951
Practice Address - Country:US
Practice Address - Phone:559-991-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)