Provider Demographics
NPI:1346645181
Name:MASON, SARA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:415-600-5555
Mailing Address - Fax:415-558-7035
Practice Address - Street 1:45 CASTRO ST STE 220
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1027
Practice Address - Country:US
Practice Address - Phone:415-600-5555
Practice Address - Fax:415-558-7035
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32210103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical