Provider Demographics
NPI:1336608645
Name:SAKRADSE, MAIA JANE (MD)
Entity Type:Individual
Prefix:
First Name:MAIA
Middle Name:JANE
Last Name:SAKRADSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 LAS POSITAS RD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-9627
Mailing Address - Country:US
Mailing Address - Phone:925-243-2600
Mailing Address - Fax:
Practice Address - Street 1:3000 LAS POSITAS RD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-9627
Practice Address - Country:US
Practice Address - Phone:925-243-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-16
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1808-7207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology