Healthcare Provider Details

I. General information

NPI: 1255471314
Provider Name (Legal Business Name): PAULETTE SAUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 SIERRA RD APT 12 2523 EL PORTAL DR. STE. #103 SAN PABLO, CA. #94806
CONCORD CA
94518-2981
US

IV. Provider business mailing address

2010 SIERRA RD APT 12
CONCORD CA
94518-2981
US

V. Phone/Fax

Practice location:
  • Phone: 510-374-7500
  • Fax: 510-374-7504
Mailing address:
  • Phone: 510-374-7500
  • Fax: 510-374-7504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: