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General NPI Number Information
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NPI Number | 1194208983
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Entity Type | Individual
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Provider Name | TIFFANY DANIELLE SICKLER PHD
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Gender | Female
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Dates
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Enumeration Date | 09/08/2018
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 3731 MAGNOLIA ST
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City | LOOMIS
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State | CA
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Zip | 95650-8921
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Country | US
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Telephone | 916-652-5802
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1403
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City | LOOMIS
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State | CA
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Zip | 95650-1403
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Country | US
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Telephone | 916-652-5802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 30322
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License Number State | CA
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