Provider Demographics
NPI:1073622601
Name:AEED, SUMER S (EDD)
Entity type:Individual
Prefix:
First Name:SUMER
Middle Name:S
Last Name:AEED
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7732
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:7010 E ACOMA DR
Practice Address - Street 2:SUITE A203
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3553
Practice Address - Country:US
Practice Address - Phone:480-607-1022
Practice Address - Fax:480-367-1160
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3443103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ68203Medicare PIN
AZZ78962Medicare PIN
AZZ128090Medicare PIN