Provider Demographics
NPI:1316420474
Name:KLEINSASSER, SARAHJANE (CADC II)
Entity type:Individual
Prefix:MISS
First Name:SARAHJANE
Middle Name:
Last Name:KLEINSASSER
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:KLEINSASSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CADC-II
Mailing Address - Street 1:285 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3501
Mailing Address - Country:US
Mailing Address - Phone:530-662-2699
Mailing Address - Fax:
Practice Address - Street 1:500 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:W SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95605-2350
Practice Address - Country:US
Practice Address - Phone:530-554-0924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
CAA051760420101YA0400X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA051760420OtherCCAPP-CADC-II