Provider Demographics
NPI:1881275295
Name:SINGHAKUL, SIRIRAT SARA (LCSW)
Entity type:Individual
Prefix:MS
First Name:SIRIRAT
Middle Name:SARA
Last Name:SINGHAKUL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8349 MURIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-3734
Mailing Address - Country:US
Mailing Address - Phone:818-357-0959
Mailing Address - Fax:
Practice Address - Street 1:8349 MURIETTA AVE
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-3734
Practice Address - Country:US
Practice Address - Phone:818-357-0959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1010851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty