Provider Demographics
NPI:1649462276
Name:JOHN D. SAWYER, PHD
Entity type:Organization
Organization Name:JOHN D. SAWYER, PHD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:714-871-9732
Mailing Address - Street 1:680 LANGSDORF DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3702
Mailing Address - Country:US
Mailing Address - Phone:714-871-9732
Mailing Address - Fax:714-871-4561
Practice Address - Street 1:680 LANGSDORF DR
Practice Address - Street 2:SUITE 219
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3702
Practice Address - Country:US
Practice Address - Phone:714-871-9732
Practice Address - Fax:714-871-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 11021103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP 11021Medicare PIN