1861509069 NPI number — DR. SONDRA JEAN MEHLHOP PSYCHOLOGIST

Table of content: DR. SONDRA JEAN MEHLHOP PSYCHOLOGIST (NPI 1861509069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861509069 NPI number — DR. SONDRA JEAN MEHLHOP PSYCHOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEHLHOP
Provider First Name:
SONDRA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYCHOLOGIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MESCHER
Provider Other First Name:
SANDRA
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1861509069
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4215 SPRING STREET
Provider Second Line Business Mailing Address:
SUITE 325
Provider Business Mailing Address City Name:
LA MESA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91941
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-462-2277
Provider Business Mailing Address Fax Number:
619-462-2465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4215 SPRING STREET
Provider Second Line Business Practice Location Address:
SUITE 325
Provider Business Practice Location Address City Name:
LA MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91941
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-462-2277
Provider Business Practice Location Address Fax Number:
619-462-2465
Provider Enumeration Date:
08/24/2006

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: 103T00000X , with the licence number:  PS412374 , 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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