Provider Demographics
NPI:1124428834
Name:SZYMCZAK, SARA JEAN (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JEAN
Last Name:SZYMCZAK
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-2152
Mailing Address - Country:US
Mailing Address - Phone:708-334-7511
Mailing Address - Fax:414-238-9407
Practice Address - Street 1:2261 MARKET ST STE 10222
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1612
Practice Address - Country:US
Practice Address - Phone:708-334-7511
Practice Address - Fax:414-238-9407
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ219395363LP0808X
TX1006442363LP0808X
WI16208363LP0808X
OK209475363LP0808X
NC5014155363LP0808X
WI190885163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse