Healthcare Provider Details

I. General information

NPI: 1992838478
Provider Name (Legal Business Name): SANGINI D SOOD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 EXECUTIVE PARK BLVD SUITE 4900
SAN FRANCISCO CA
94134-3394
US

IV. Provider business mailing address

250 EXECUTIVE PARK BLVD SUITE 4900
SAN FRANCISCO CA
94134-3394
US

V. Phone/Fax

Practice location:
  • Phone: 415-656-0116
  • Fax: 415-656-0117
Mailing address:
  • Phone: 415-656-0116
  • Fax: 415-656-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY22264
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: