Healthcare Provider Details

I. General information

NPI: 1972720795
Provider Name (Legal Business Name): KAREN ANNE SANDERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 1ST ST W
SONOMA CA
95476-7036
US

IV. Provider business mailing address

793 1ST ST W
SONOMA CA
95476-7036
US

V. Phone/Fax

Practice location:
  • Phone: 707-996-9802
  • Fax: 707-996-9318
Mailing address:
  • Phone: 707-996-9802
  • Fax: 707-996-9318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS10874
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: