Sarah Clevenger, PH.D.
Individual provider Active NPI Clinical Psychologist · Represa, CA
NPI 1093077448 · NPPES record last updated Oct 15, 2023
Key facts
- NPI
- 1093077448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY24202 (CA)
- Practice address
- 100 Prison Rd
Represa, CA 95671-0002 - Phone
- (916) 985-8610
- NPI assigned
- Jun 12, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY24202 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LGTC Inc | Past |
Accepting new patients | |
| WK Medical Group | Clinical | Past |
Accepting new patients |
| Los Gatos Therapy Center | Past |
Accepting new patients | |
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients | |
| LGTC Group | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY24202 | CA | Yes |
Addresses
Primary practice location
100 Prison Rd
Represa, CA 95671-0002
Mailing address
PO Box 290002
Represa, CA 95671-0002
Other providers in Represa, CA
- Jacqueline Daasch Caoile
- Isidro Acosta Cardeno
- Adielle Carrington
- Meg Eu Cho
- Stephen Joseph Clavere
- Daniela Coppin
- Corrections and Rehabilitation-Headquarters
- Corrections and Rehabilitation-Headquarters
- Natalie S Coss
- Joseph A Costa
All providers in Represa, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.