Provider Demographics
NPI:1053561050
Name:SAECHAO, SOU CHIANG
Entity type:Individual
Prefix:
First Name:SOU
Middle Name:CHIANG
Last Name:SAECHAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SOU
Other - Middle Name:CHIANG
Other - Last Name:SAECHAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4330 AUBURN BLVD STE 2200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4155
Mailing Address - Country:US
Mailing Address - Phone:916-473-5764
Mailing Address - Fax:916-473-5766
Practice Address - Street 1:4330 AUBURN BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4155
Practice Address - Country:US
Practice Address - Phone:916-473-5764
Practice Address - Fax:916-473-5766
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)