Provider Demographics
NPI:1992838478
Name:SOOD, SANGINI D (PSYD)
Entity type:Individual
Prefix:DR
First Name:SANGINI
Middle Name:D
Last Name:SOOD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 EXECUTIVE PARK BLVD
Mailing Address - Street 2:SUITE 4900
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-3394
Mailing Address - Country:US
Mailing Address - Phone:415-656-0116
Mailing Address - Fax:415-656-0117
Practice Address - Street 1:250 EXECUTIVE PARK BLVD
Practice Address - Street 2:SUITE 4900
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-3394
Practice Address - Country:US
Practice Address - Phone:415-656-0116
Practice Address - Fax:415-656-0117
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22264103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent