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General NPI Number Information
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NPI Number | 1992918411
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Entity Type | Individual
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Provider Name | SANDRA DICKEY HARNER PHD
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 TAMAL PLAZA SUITE 195
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City | CORTE MADERA
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State | CA
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Zip | 94925
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Country | US
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Telephone | 415-721-4570
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Fax | 415-380-9071
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Provider Business Mailing Address
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Address Line | PO BOX 1709
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City | MILL VALLEY
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State | CA
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Zip | 94942
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Country | US
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Telephone | 415-380-9475
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Fax | 415-380-9071
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 15790
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License Number State | CA
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