Healthcare Provider Details

I. General information

NPI: 1689041196
Provider Name (Legal Business Name): KAO SAETERN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3123 INDEPENDENCE DR
LIVERMORE CA
94551-7595
US

IV. Provider business mailing address

3473 VERNAL AVE
MERCED CA
95340-0637
US

V. Phone/Fax

Practice location:
  • Phone: 925-999-4119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number72094
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: