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NPI Code Detail

MEDICARE: DR. KARLA ANN SAGRAMOSO PHD

MEDICARE: DR. KARLA ANN SAGRAMOSO PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent Psychologist14104CA
2103TC0700XClinical PsychologistPSY14104CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OPL141040OTHERCABLUE SHIELD
276083OTHERCAMHN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649213307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KARLA ANN SAGRAMOSO PHD
Provider Business Mailing Address
First Line : 770 53RD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-1814
Country : US
Telephone Number : 510-459-6893
Fax Number :
Provider Business Practice Location Address
First Line : 770 53RD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-1814
Country : US
Telephone Number : 510-459-6893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 06/16/2023

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