Sage Educational Psychology Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SAGE EDUCATIONAL PSYCHOLOGY INC

Practice address

350 College Ave Ste 101
Santa Rosa, CA 95401-5125

Phone

(707) 852-1630

NPI assigned

Oct 24, 2024

Last updated

Oct 24, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julia Vander Vennet

Title

Ceo

Phone

(707) 852-1630

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1275355901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5247 BEAUMONT WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 COLLEGE AVE STE 101",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015125",
            "telephone_number": "707-852-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE EDUCATIONAL PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "VANDER VENNET",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-852-1630"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.