Basic Information
Provider Information
NPI: 1972965291
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARONOW-WERNER
FirstName: SARAH PEARL
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1550 GATEWAY BLVD
Address2:  
City: FAIRFIELD
State: CA
PostalCode: 945336901
CountryCode: US
TelephoneNumber: 7075133677
FaxNumber:  
Practice Location
Address1: 275 W MACARTHUR BLVD
Address2:  
City: OAKLAND
State: CA
PostalCode: 946115641
CountryCode: US
TelephoneNumber: 5107521000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2016
LastUpdateDate: 01/17/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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