Provider Demographics
NPI:1558589630
Name:CAREY, SARAH (MS CCCS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CAREY
Suffix:
Gender:F
Credentials:MS CCCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 CAMINO RAMON
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-2000
Mailing Address - Country:US
Mailing Address - Phone:925-830-5094
Mailing Address - Fax:801-760-0469
Practice Address - Street 1:2301 CAMINO RAMON
Practice Address - Street 2:SUITE 106
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-2000
Practice Address - Country:US
Practice Address - Phone:925-830-5094
Practice Address - Fax:801-760-0469
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1466231H00000X
CAHA 3123237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA 3123OtherDISPENSING LICENSE
CAAU 1466OtherAUDIOLOGY LICENSE
CAHA 3123OtherDISPENSING LICENSE