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General NPI Number Information
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NPI Number | 1205018900
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Entity Type | Organization
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Legal Business Name | PSYCHIATRY AND COUNSELING
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1050 E SOUTHERN AVE G 1
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City | TEMPE
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State | AZ
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Zip | 85282-5403
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Country | US
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Telephone | 480-966-1485
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Fax | 480-968-5020
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Provider Business Mailing Address
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Address Line | PO BOX 23687
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City | TEMPE
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State | AZ
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Zip | 85285-3687
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Country | US
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Telephone | 480-966-1485
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Fax | 480-968-5020
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. SARDEV S SIDHU
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Credential | M.D.
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Telephone | 480-966-1485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | AZ
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