Provider Demographics
NPI:1639200850
Name:STADLER, SARAH LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:LEWIS
Last Name:STADLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 HEARST AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-2130
Mailing Address - Country:US
Mailing Address - Phone:510-486-8132
Mailing Address - Fax:888-455-9491
Practice Address - Street 1:2000 HEARST AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-2130
Practice Address - Country:US
Practice Address - Phone:510-486-8132
Practice Address - Fax:888-455-9491
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG601982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG60198OtherMEDICAL LICENSE
BS0147606OtherDEA
BS0147606OtherDEA