Provider Demographics
NPI:1104821230
Name:SAUNDERS, WALTER CRUCE JR (PHD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:CRUCE
Last Name:SAUNDERS
Suffix:JR
Gender:M
Credentials:PHD
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Mailing Address - Street 1:7861 PRESTWICK CIR
Mailing Address - Street 2:STE A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-2143
Mailing Address - Country:US
Mailing Address - Phone:408-270-0165
Mailing Address - Fax:408-270-0166
Practice Address - Street 1:7861 PRESTWICK CIR
Practice Address - Street 2:STE A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-2143
Practice Address - Country:US
Practice Address - Phone:408-270-0165
Practice Address - Fax:408-270-0166
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY006301103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY006301OtherCA LICENSE NUMBER
CAPSY006301OtherCA LICENSE NUMBER