Provider Demographics
NPI:1043556863
Name:BORDERS, ORIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ORIN
Middle Name:
Last Name:BORDERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 21ST ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-1752
Mailing Address - Country:US
Mailing Address - Phone:530-448-9177
Mailing Address - Fax:
Practice Address - Street 1:2015 21ST ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-1752
Practice Address - Country:US
Practice Address - Phone:530-448-9177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8742103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist