Healthcare Provider Details

I. General information

NPI: 1497034037
Provider Name (Legal Business Name): SARAH NICHOLE MUNOZ PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2011
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 KINGLET RD
LIVERMORE CA
94551-6133
US

IV. Provider business mailing address

478 KINGLET RD
LIVERMORE CA
94551-6133
US

V. Phone/Fax

Practice location:
  • Phone: 858-729-3437
  • Fax:
Mailing address:
  • Phone: 858-729-3437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY26378
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number019836-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1206631
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number101201471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: