Provider Demographics
NPI:1962937748
Name:STRADER, SARAH (PHD, LPCC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:STRADER
Suffix:
Gender:F
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7034
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-7034
Mailing Address - Country:US
Mailing Address - Phone:650-336-5159
Mailing Address - Fax:
Practice Address - Street 1:1132 MCKENDRIE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1406
Practice Address - Country:US
Practice Address - Phone:650-336-5159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional