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General NPI Number Information
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NPI Number | 1649200593
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Entity Type | Individual
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Provider Name | KARMEL PENGILLY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1330 Q ST
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City | SACRAMENTO
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State | CA
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Zip | 95814-5805
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Country | US
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Telephone | 916-443-5707
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Fax | 916-443-5707
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Provider Business Mailing Address
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Address Line | 7610 RUSH RIVER DR #115
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City | SACRAMENTO
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State | CA
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Zip | 95831-5516
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Country | US
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Telephone | 916-429-0284
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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 | PSY 18449
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP0188
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License Number State | MN
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