Provider Demographics
NPI:1003043910
Name:GILES, SOPHIE P (PHD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIE
Middle Name:P
Last Name:GILES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W PARR AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1442
Mailing Address - Country:US
Mailing Address - Phone:408-907-3194
Mailing Address - Fax:408-370-9208
Practice Address - Street 1:700 PARR AVENUE
Practice Address - Street 2:SUITE K
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1444
Practice Address - Country:US
Practice Address - Phone:408-907-3194
Practice Address - Fax:408-370-9208
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 19932103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical