Provider Demographics
NPI:1831250406
Name:SAUNDERS, MARGUERITE A (PSYD)
Entity type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:A
Last Name:SAUNDERS
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 1:2810 E DEL MAR BLVD
Mailing Address - Street 2:#4
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-4321
Mailing Address - Country:US
Mailing Address - Phone:626-356-3936
Mailing Address - Fax:
Practice Address - Street 1:2810 E DEL MAR BLVD
Practice Address - Street 2:#4
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4321
Practice Address - Country:US
Practice Address - Phone:626-356-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18334103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP18334AMedicare ID - Type Unspecified