Provider Demographics
NPI:1083044960
Name:SAUTTER, FREDERICK ROOT JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:ROOT
Last Name:SAUTTER
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 KIRKLAND LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-7209
Mailing Address - Country:US
Mailing Address - Phone:707-481-7744
Mailing Address - Fax:877-349-6094
Practice Address - Street 1:1430 BLUE OAKS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-5156
Practice Address - Country:US
Practice Address - Phone:707-481-7744
Practice Address - Fax:877-349-6094
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9006-C1041C0700X
AR7896-C1041C0700X
CALCSW723081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical