Provider Demographics
NPI:1487636668
Name:SAVAGE, GALYN MARION (PHD)
Entity Type:Individual
Prefix:DR
First Name:GALYN
Middle Name:MARION
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 FAIRVIEW LN
Mailing Address - Street 2:SUITE F
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-4828
Mailing Address - Country:US
Mailing Address - Phone:209-536-3277
Mailing Address - Fax:209-558-8868
Practice Address - Street 1:193 FAIRVIEW LN
Practice Address - Street 2:SUITE F
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-4828
Practice Address - Country:US
Practice Address - Phone:209-536-3277
Practice Address - Fax:209-558-8868
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAPSY14914103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical