Organization
SAGE EDUCATIONAL PSYCHOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA VANDER VENNET (CEO)
(707) 852-1630
Entity
Organization
Contact information
Practice address
350 COLLEGE AVE STE 101, SANTA ROSA, CA 95401-5125
(707) 852-1630
Mailing address
5247 BEAUMONT WAY, SANTA ROSA, CA 95409-2811
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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