Provider Demographics
NPI:1386653418
Name:BORIS, SYLVIA (PHD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:BORIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16111 PLUMMER STREET
Mailing Address - Street 2:VETERANS ADMINISTRATION (116B)
Mailing Address - City:SEPULVEDA
Mailing Address - State:CA
Mailing Address - Zip Code:90064
Mailing Address - Country:US
Mailing Address - Phone:818-891-7711
Mailing Address - Fax:818-895-5883
Practice Address - Street 1:16111 PLUMMER STREET
Practice Address - Street 2:VETERANS ADMINISTRATION (116B)
Practice Address - City:SEPULVEDA
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:818-891-7711
Practice Address - Fax:818-895-5883
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11927103T00000X, 103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)