Provider Demographics
NPI:1073939518
Name:SONNEE WEEDN, PHD, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SONNEE WEEDN, PHD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONNEE
Authorized Official - Middle Name:DELIGHT
Authorized Official - Last Name:WEEDN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-883-7758
Mailing Address - Street 1:3 HAMILTON LNDG
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-8248
Mailing Address - Country:US
Mailing Address - Phone:415-883-7758
Mailing Address - Fax:415-883-8385
Practice Address - Street 1:3 HAMILTON LNDG
Practice Address - Street 2:SUITE 230
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-8248
Practice Address - Country:US
Practice Address - Phone:415-883-7758
Practice Address - Fax:415-883-8385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12188103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty