Provider Demographics
NPI:1235884313
Name:SIVORI, KENT JOHN
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:JOHN
Last Name:SIVORI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9312 LANCASHIRE CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-4762
Mailing Address - Country:US
Mailing Address - Phone:916-709-7840
Mailing Address - Fax:
Practice Address - Street 1:3820 AUBURN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2124
Practice Address - Country:US
Practice Address - Phone:916-300-6576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling