1336397033 NPI number — DR. SINDHU ELIZABETH PHILIP PSY.D.

Table of content: DR. SINDHU ELIZABETH PHILIP PSY.D. (NPI 1336397033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336397033 NPI number — DR. SINDHU ELIZABETH PHILIP PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PHILIP
Provider First Name:
SINDHU
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PHILIP
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
SINDHU
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSY.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1336397033
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2241 HARVARD ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95815-3305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-978-6400
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2241 HARVARD ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95815-3305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-978-6400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSB 34959 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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