Provider Demographics
NPI:1306128442
Name:DAVID, SARAH BROWN (PSYD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BROWN
Last Name:DAVID
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S EL CAMINO REAL
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1726
Mailing Address - Country:US
Mailing Address - Phone:650-342-8400
Mailing Address - Fax:
Practice Address - Street 1:520 S EL CAMINO REAL
Practice Address - Street 2:SUITE 204
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1726
Practice Address - Country:US
Practice Address - Phone:650-342-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22025103TC0700X
MI6301018194103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical