Provider Demographics
NPI:1285287268
Name:PEACEFUL SUNSHINE PSYCHOLOGY INC.
Entity type:Organization
Organization Name:PEACEFUL SUNSHINE PSYCHOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:JOTZU
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:510-560-4930
Mailing Address - Street 1:3235 BEARD RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2236
Mailing Address - Country:US
Mailing Address - Phone:510-560-4930
Mailing Address - Fax:
Practice Address - Street 1:46808 LAKEVIEW BLVD STE 102
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-6543
Practice Address - Country:US
Practice Address - Phone:510-560-4930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
4136D525-A990-4B12-BOtherLYRA