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General NPI Number Information
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NPI Number | 1407908411
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Entity Type | Individual
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Provider Name | ROY JACKSON PHILLIPS PHD
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 01/04/2026
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Provider Practice Location Address
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Address Line | 2025 MORSE AVE KAISER PERMANENTE, DEPT OF PSYCHIATRY
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City | SACRAMENTO
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State | CA
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Zip | 95825
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Country | US
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Telephone | 916-793-4473
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Fax |
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Provider Business Mailing Address
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Address Line | 7500 ITCHY ACRES ROAD
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City | GRANITE BAY
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State | CA
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Zip | 95746
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Country | US
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Telephone | 916-797-9950
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY1927
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License Number State | CA
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