Provider Demographics
NPI:1205011442
Name:SIPHERD, ERIN ELIZABETH (MA)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:SIPHERD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 AUBURN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-1831
Mailing Address - Country:US
Mailing Address - Phone:916-483-2154
Mailing Address - Fax:
Practice Address - Street 1:313 JUDAH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2651
Practice Address - Country:US
Practice Address - Phone:530-613-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF55239106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist