Active NPI
Angela Christine Sanders, PSY.D.
- Clinical Psychologist
- Waterford, WI
National Provider Identifier
1215176367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2933-057
- Practice address
- 1701 Sharp Rd
Waterford, WI 53185-5214 - Phone
- (262) 534-8522
- NPI assigned
- Feb 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2933-057 | WI | Primary |
Addresses
Primary practice location
1701 Sharp Rd
Waterford, WI 53185-5214
Mailing address
1701 Sharp Rd
Waterford, WI 53185-5214
Phone (262) 534-8522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43722900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2933-057 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312243200000",
"number": "1215176367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 SHARP RD",
"city": "WATERFORD",
"state": "WI",
"postal_code": "531855214",
"telephone_number": "262-534-8522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 SHARP RD",
"city": "WATERFORD",
"state": "WI",
"postal_code": "531855214",
"telephone_number": "262-534-8522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "ANGELA",
"middle_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-12",
"last_updated": "2011-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "2933-057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43722900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterford, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.