Provider Demographics
NPI:1952835423
Name:DUDENHOEFFER, SARAH (DO)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:DUDENHOEFFER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:DUDENHOEFFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:421 MARCH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3367
Mailing Address - Country:US
Mailing Address - Phone:707-433-5511
Mailing Address - Fax:
Practice Address - Street 1:421 MARCH AVE STE B
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3367
Practice Address - Country:US
Practice Address - Phone:707-433-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A20658207Q00000X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program