Provider Demographics
NPI:1912993908
Name:SACHS, KARL L (PSYD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:L
Last Name:SACHS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 E PIMA ST
Mailing Address - Street 2:105 A
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3664
Mailing Address - Country:US
Mailing Address - Phone:520-869-4166
Mailing Address - Fax:520-795-3575
Practice Address - Street 1:5210 E PIMA ST
Practice Address - Street 2:SUITE 105 A
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3664
Practice Address - Country:US
Practice Address - Phone:520-869-4166
Practice Address - Fax:520-795-3575
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3189103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ105544Medicare PIN