Provider Demographics
NPI:1740001981
Name:SIERRA TAHOE PSYCHIATRY ASSOCIATES
Entity type:Organization
Organization Name:SIERRA TAHOE PSYCHIATRY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:FRY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:775-391-0444
Mailing Address - Street 1:PO BOX 34120
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89533-4120
Mailing Address - Country:US
Mailing Address - Phone:877-747-5050
Mailing Address - Fax:775-747-5005
Practice Address - Street 1:505 S ARLINGTON AVE STE 106
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-1505
Practice Address - Country:US
Practice Address - Phone:775-391-0444
Practice Address - Fax:775-870-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty