Basic Information
Provider Information
NPI: 1295053494
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARAN
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 214 CENTERVIEW DR
Address2: SUITE 100
City: BRENTWOOD
State: TN
PostalCode: 370275274
CountryCode: US
TelephoneNumber: 6153455390
FaxNumber:  
Practice Location
Address1: 2025 MORSE AVE
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958252115
CountryCode: US
TelephoneNumber: 9169736847
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/12/2010
LastUpdateDate: 10/27/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246ZE0600X  Y Technologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic

No ID Information.


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