Provider Demographics
NPI:1437821261
Name:LEVY, SARA PAIGE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:PAIGE
Last Name:LEVY
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
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:415-600-0940
Mailing Address - Fax:415-387-0730
Practice Address - Street 1:3838 CALIFORNIA ST RM 805
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1510
Practice Address - Country:US
Practice Address - Phone:415-600-0940
Practice Address - Fax:415-387-0730
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59957363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA59957OtherSTATE MEDICAL LICENSE