Healthcare Provider Details

I. General information

NPI: 1306510128
Provider Name (Legal Business Name): SARAH JEAN ANDARY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 CAL CENTER DR STE 120
SACRAMENTO CA
95826-3247
US

IV. Provider business mailing address

500 W. HAMILTON AVE. P.O. BOX 110384
CAMPBELL CA
95011
US

V. Phone/Fax

Practice location:
  • Phone: 916-707-1758
  • Fax: 916-200-3191
Mailing address:
  • Phone: 916-572-5375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138687
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number112408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: