Provider Demographics
NPI:1841921020
Name:HIPES, SARIESA FAYE
Entity type:Individual
Prefix:
First Name:SARIESA
Middle Name:FAYE
Last Name:HIPES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARIESA
Other - Middle Name:
Other - Last Name:BOELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:410 JONES ST STE C1
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5491
Mailing Address - Country:US
Mailing Address - Phone:707-463-0405
Mailing Address - Fax:
Practice Address - Street 1:410 JONES ST STE C1
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5491
Practice Address - Country:US
Practice Address - Phone:707-463-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician