Provider Demographics
NPI:1083817654
Name:STURGES, STEPHEN PATTERSON (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:PATTERSON
Last Name:STURGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 DWIGHT WAY STE 303
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-2633
Mailing Address - Country:US
Mailing Address - Phone:510-548-1189
Mailing Address - Fax:510-548-1189
Practice Address - Street 1:2006 DWIGHT WAY STE 303
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2633
Practice Address - Country:US
Practice Address - Phone:510-548-1189
Practice Address - Fax:510-548-1189
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG239002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42098Medicare UPIN