The answer I received from the PayPal developer forums was:
A payer_id is returned whether the
buyer pays with a PayPal account or
uses their credit card without logging
into an account.
You can generate test card number in
the sandbox by following the steps
below:
First login to your buyer sandbox
account and generate a test credit
card by following the steps below:
Click on Profile
Click on Credit card
Click on Add
Select the card type (currently, the
sandbox will generate test visa card
numbers)
Copy the card here and click on cancel
** Don't add the card to your account**
Now use this test card number, any
expiration date in the future, 000 for
the CVV2 number, any address in a
valid format and any name to test
again.
These test cards will result in a
success. For website payments
standard, to simulate failure with a
test card number, you can enter any
random 16 digits for the card number.
However, with website payments
standard, if a transaction fails, no
response is sent to the merchant.
Thanks.