MEDICARE: CARLA SAVAGE-SACHS

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
1	106H00000X	Marriage & Family Therapist	107306	CA

General Provider Information

NPI Number	:	1780163428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA SAVAGE-SACHS

Provider Business Mailing Address
First Line	:	640 LILAC DR
Second Line	:
City	:	LOS OSOS
State	:	CA
Zip	:	93402-3822
Country	:	US
Telephone Number	:	805-235-6314
Fax Number	:

Provider Business Practice Location Address
First Line	:	2231 BAYVIEW HEIGHTS DR
Second Line	:
City	:	LOS OSOS
State	:	CA
Zip	:	93402-3900
Country	:	US
Telephone Number	:	805-235-6314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2018
Last Update Date	:	08/13/2018

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