Provider Demographics
NPI:1083881957
Name:HYATT, SARA H (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:H
Last Name:HYATT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:H
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:4320 STEVENS CREEK BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-1202
Mailing Address - Country:US
Mailing Address - Phone:408-888-7324
Mailing Address - Fax:408-866-4766
Practice Address - Street 1:4320 STEVENS CREEK BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-1202
Practice Address - Country:US
Practice Address - Phone:408-888-7324
Practice Address - Fax:408-866-4766
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22635103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL226350OtherBLUE SHIELD PIN