Provider Demographics
NPI:1114258787
Name:SANDERS, SARA MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:MARIE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:GOUIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:7901 STONERIDGE DR
Mailing Address - Street 2:SUITE 521
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3677
Mailing Address - Country:US
Mailing Address - Phone:925-216-5651
Mailing Address - Fax:
Practice Address - Street 1:7901 STONERIDGE DR
Practice Address - Street 2:SUITE 521
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3677
Practice Address - Country:US
Practice Address - Phone:925-216-5651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22583103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical