Provider Demographics
NPI:1306861273
Name:WOERNER, SARAH J (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:WOERNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O BOX 459001
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-9109
Mailing Address - Country:US
Mailing Address - Phone:530-272-9780
Mailing Address - Fax:530-272-0156
Practice Address - Street 1:140 LITTON DR STE 100
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5078
Practice Address - Country:US
Practice Address - Phone:530-272-9780
Practice Address - Fax:530-272-0156
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34453208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G344530Medicare ID - Type UnspecifiedPROVIDER ID NUMBER