Provider Demographics
NPI:1669697165
Name:SANDERS, DARRYL EUGENE (ASW)
Entity type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:EUGENE
Last Name:SANDERS
Suffix:
Gender:M
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11434 B AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2603
Mailing Address - Country:US
Mailing Address - Phone:530-886-2928
Mailing Address - Fax:530-889-7293
Practice Address - Street 1:11434 STE 200 B AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2506
Practice Address - Country:US
Practice Address - Phone:530-886-2928
Practice Address - Fax:530-889-7293
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 21607101YM0800X
CAASW897871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health