Provider Demographics
NPI:1154460970
Name:POUNDS, DAVID SIDNEY (PHD PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SIDNEY
Last Name:POUNDS
Suffix:
Gender:M
Credentials:PHD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1600
Mailing Address - Street 2:
Mailing Address - City:COARSEGOLD
Mailing Address - State:CA
Mailing Address - Zip Code:93614-1600
Mailing Address - Country:US
Mailing Address - Phone:559-683-3365
Mailing Address - Fax:
Practice Address - Street 1:42111 RD 415
Practice Address - Street 2:
Practice Address - City:COARSEGOLD
Practice Address - State:CA
Practice Address - Zip Code:93614-1600
Practice Address - Country:US
Practice Address - Phone:559-683-3365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12409103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY124090Medicaid
CACP12409Medicare ID - Type Unspecified