Provider Demographics
NPI:1336397033
Name:PHILIP, SINDHU ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SINDHU
Middle Name:ELIZABETH
Last Name:PHILIP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:SINDHU
Other - Last Name:PHILIP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:2241 HARVARD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-3305
Mailing Address - Country:US
Mailing Address - Phone:916-978-6400
Mailing Address - Fax:
Practice Address - Street 1:2241 HARVARD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-3305
Practice Address - Country:US
Practice Address - Phone:916-978-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB 34959103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical