Healthcare Provider Details

I. General information

NPI: 1720268535
Provider Name (Legal Business Name): SHERRY JUDY LOEWINGER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CALIFORNIA DR
VACAVILLE CA
95687
US

IV. Provider business mailing address

PO BOX 21114
PIEDMONT CA
94620-1114
US

V. Phone/Fax

Practice location:
  • Phone: 707-448-6841
  • Fax:
Mailing address:
  • Phone: 310-892-6451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: