Provider Demographics
NPI:1225235732
Name:SAMMIS, JEFFERY MORGAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:MORGAN
Last Name:SAMMIS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:919 SIR FRANCIS DRAKE BLVD STE 201A
Mailing Address - Street 2:
Mailing Address - City:KENTFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1535
Mailing Address - Country:US
Mailing Address - Phone:415-373-6422
Mailing Address - Fax:415-366-1627
Practice Address - Street 1:919 SIR FRANCIS DRAKE BLVD STE 201A
Practice Address - Street 2:
Practice Address - City:KENTFIELD
Practice Address - State:CA
Practice Address - Zip Code:94904-1535
Practice Address - Country:US
Practice Address - Phone:415-373-6422
Practice Address - Fax:415-366-1627
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25029103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist