Healthcare Provider Details

I. General information

NPI: 1568441590
Provider Name (Legal Business Name): SIDNEY RAPIER CORMIER JR. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1158 N COURT ST
REDDING CA
96001-0436
US

IV. Provider business mailing address

1364 EMPRESS LN
REDDING CA
96002-5069
US

V. Phone/Fax

Practice location:
  • Phone: 530-209-9710
  • Fax:
Mailing address:
  • Phone: 530-209-9710
  • Fax: 176-068-3605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY6659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: