Provider Demographics
NPI:1992538706
Name:MORENO, SARAH ANGELICA
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANGELICA
Last Name:MORENO
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 1:1761 GOLDEN GATE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-4437
Mailing Address - Country:US
Mailing Address - Phone:323-376-9725
Mailing Address - Fax:
Practice Address - Street 1:NORTHEASTERN UNIVERSITY IN OAKLAND
Practice Address - Street 2:5000 MACARTHUR BLVD
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94613
Practice Address - Country:US
Practice Address - Phone:323-376-9725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program