Provider Demographics
NPI:1306530746
Name:SARNO, ETHINA LERESE
Entity type:Individual
Prefix:
First Name:ETHINA
Middle Name:LERESE
Last Name:SARNO
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 1:8640 ILDICA ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-3522
Mailing Address - Country:US
Mailing Address - Phone:619-573-2793
Mailing Address - Fax:
Practice Address - Street 1:7297 RONSON RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1427
Practice Address - Country:US
Practice Address - Phone:858-278-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician