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NPI 1851641765

NPI 1851641765 : DALE SIPERSTEIN PHD : PLEASANTON, CA

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General NPI Number Information
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    NPI Number           |    1851641765
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    Entity Type          |    Individual 
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    Provider Name        |    DALE SIPERSTEIN PHD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/18/2012
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    Last Update Date     |    09/18/2012
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Provider Practice Location Address
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    Address Line         |    5674 STONERIDGE DR STE 218 
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    City                 |    PLEASANTON
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    State                |    CA
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    Zip                  |    94588-8532
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    Country              |    US
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    Telephone            |    925-484-5441
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5674 STONERIDGE DR STE 218 
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    City                 |    PLEASANTON
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    State                |    CA
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    Zip                  |    94588-8532
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    Country              |    US
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    Telephone            |    
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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        |    103TC2200X
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    Taxonomy Name        |    Clinical Child & Adolescent Psychologist
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    License Number       |    13047
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    License Number State |    CA
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