Healthcare Provider Details

I. General information

NPI: 1447710330
Provider Name (Legal Business Name): SONIA AMIN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 MARKET ST
SAN FRANCISCO CA
94102-3099
US

IV. Provider business mailing address

377 LAKE RIDGE DR
KALAMAZOO MI
49006-8308
US

V. Phone/Fax

Practice location:
  • Phone: 415-632-1010
  • Fax:
Mailing address:
  • Phone: 734-837-2696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number33185
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: