Healthcare Provider Details

I. General information

NPI: 1851074496
Provider Name (Legal Business Name): SYDNEY KARAHALIOS PMHNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SYDNEY CARLIER RN

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5060 SHOREHAM PL STE 330
SAN DIEGO CA
92122-5976
US

IV. Provider business mailing address

5060 SHOREHAM PL STE 330
SAN DIEGO CA
92122-5976
US

V. Phone/Fax

Practice location:
  • Phone: 650-863-6564
  • Fax:
Mailing address:
  • Phone: 650-863-6564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95027378
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number266146
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95340470
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: