Provider Demographics
NPI:1427315639
Name:PELANGKA, SARAH ELIZABETH (PH D, BCBA-D, ESC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:PELANGKA
Suffix:
Gender:F
Credentials:PH D, BCBA-D, ESC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26468 PASEO DEL MAR
Mailing Address - Street 2:APT. D
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-5112
Mailing Address - Country:US
Mailing Address - Phone:310-597-0060
Mailing Address - Fax:
Practice Address - Street 1:26468 PASEO DEL MAR
Practice Address - Street 2:APT. D
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-5112
Practice Address - Country:US
Practice Address - Phone:310-597-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst