Healthcare Provider Details

I. General information

NPI: 1528977998
Provider Name (Legal Business Name): DELAPLAINE SIGURD JOHANSEN PH.D. PPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HEMLOCK ST
VACAVILLE CA
95688-2616
US

IV. Provider business mailing address

1931 MARSHALL RD
VACAVILLE CA
95687-5197
US

V. Phone/Fax

Practice location:
  • Phone: 707-453-6246
  • Fax:
Mailing address:
  • Phone: 979-436-2491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number240298562
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: