MEDICARE: AHMED SABRY EL-SOKKARY PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist
2	103TC2200X	Clinical Child & Adolescent Psychologist	19049	CA
3	103TC0700X	Clinical Psychologist	PSY 19049	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619169380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMED SABRY EL-SOKKARY PSYD

Provider Business Mailing Address
First Line	:	1970 BROADWAY STE 835
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-2299
Country	:	US
Telephone Number	:	415-596-1372
Fax Number	:	510-452-4281

Provider Business Practice Location Address
First Line	:	1970 BROADWAY STE 835
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-2299
Country	:	US
Telephone Number	:	415-596-1372
Fax Number	:	888-506-6612

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	11/14/2023

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