Healthcare Provider Details
I. General information
NPI: 1033421920
Provider Name (Legal Business Name): SARAH RENEE CLAUSSEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/08/2010
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US
IV. Provider business mailing address
23845 MCBEAN PKWY
VALENCIA CA
91355-2001
US
V. Phone/Fax
- Phone: 208-625-5187
- Fax: 208-625-6892
- Phone: 661-200-1370
- Fax: 661-200-1379
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | 20A16303 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | 108577 |
| License Number State | AK |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | 1371746 |
| License Number State | ID |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: