Healthcare Provider Details

I. General information

NPI: 1437580248
Provider Name (Legal Business Name): SARI ANN LEIVENT SANGHVI PH.D., LEP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 LEIMERT BLVD SUITE 302-A
OAKLAND CA
94602-1865
US

IV. Provider business mailing address

1425 LEIMERT BLVD SUITE 302-A
OAKLAND CA
94602-1865
US

V. Phone/Fax

Practice location:
  • Phone: 510-545-9722
  • Fax:
Mailing address:
  • Phone: 510-545-9722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3189
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: