Provider Demographics
NPI:1588001630
Name:PAULSON, SARAH (MA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PAULSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-5106
Mailing Address - Country:US
Mailing Address - Phone:408-288-6530
Mailing Address - Fax:408-288-6556
Practice Address - Street 1:400 S MONROE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-5106
Practice Address - Country:US
Practice Address - Phone:408-288-6530
Practice Address - Fax:408-288-6556
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist