Basic Information
| Provider Information | |||||||||
| NPI: | 1356518419 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BENNETT | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | GILBERT | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.PHIL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1938 BILTMORE ST NW | ||||||||
| Address2: | APT. B | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200091572 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024201896 | ||||||||
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| Practice Location | |||||||||
| Address1: | 650 CLARK WAY | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943042300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503265530 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2008 | ||||||||
| LastUpdateDate: | 05/08/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.