Provider Demographics
NPI:1396771713
Name:SAUER, CAROLYN P (PSYD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:P
Last Name:SAUER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 PLACERVILLE DR
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-3912
Mailing Address - Country:US
Mailing Address - Phone:530-642-2831
Mailing Address - Fax:
Practice Address - Street 1:309 PLACERVILLE DR
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-3912
Practice Address - Country:US
Practice Address - Phone:530-642-2831
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11857103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PLPSY118570Medicare UPIN