Provider Demographics
NPI:1629093430
Name:SAURER, CHARLENE PATRICIA (MA)
Entity Type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:PATRICIA
Last Name:SAURER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:PATRICIA
Other - Last Name:SAURER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:360 MOBIL AVE
Mailing Address - Street 2:218 G
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6325
Mailing Address - Country:US
Mailing Address - Phone:805-482-5266
Mailing Address - Fax:805-388-9010
Practice Address - Street 1:360 MOBIL AVE
Practice Address - Street 2:218 G
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6325
Practice Address - Country:US
Practice Address - Phone:805-482-5266
Practice Address - Fax:805-388-9010
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32050106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist