Healthcare Provider Details
I. General information
NPI: 1083679211
Provider Name (Legal Business Name): CHRISTY MICHELLE FIBER SIGMON PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 04/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
751 S BASCOM AVE PSYCHOLOGY SERVICES DEPARTMENT
SAN JOSE CA
95128-2604
US
IV. Provider business mailing address
PO BOX 1266
DANVILLE CA
94526-8266
US
V. Phone/Fax
- Phone: 408-885-5000
- Fax:
- Phone: 925-314-0874
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 20740 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: