Healthcare Provider Details

I. General information

NPI: 1255269163
Provider Name (Legal Business Name): SIDNEY LARYNN ORR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9161 MADISON AVE APT 29
ORANGEVALE CA
95662-5255
US

IV. Provider business mailing address

9161 MADISON AVE APT 29
ORANGEVALE CA
95662-5255
US

V. Phone/Fax

Practice location:
  • Phone: 916-370-5125
  • Fax:
Mailing address:
  • Phone: 916-370-5125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberY5964275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: