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General NPI Number Information
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NPI Number | 1588540942
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Entity Type | Individual
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Provider Name | ARDEL SUNDIE PAYNE MFT, PHD
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Gender | Female
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1101 S WINCHESTER BLVD BLDG K, SUITE 236
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City | SAN JOSE
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State | CA
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Zip | 95128
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Country | US
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Telephone | 408-247-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 S WINCHESTER BLVD BLDG K, SUITE 236
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City | SAN JOSE
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State | CA
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Zip | 95128
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Country | US
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Telephone | 408-981-1063
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Fax | 408-247-1605
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | MB18515
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License Number State | CA
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