Provider Demographics
NPI:1417480807
Name:SUN, ARTHUR SOPHYROTH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:SOPHYROTH
Last Name:SUN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CLIFF SWALLOW CT
Mailing Address - Street 2:
Mailing Address - City:BRISBANE
Mailing Address - State:CA
Mailing Address - Zip Code:94005-1242
Mailing Address - Country:US
Mailing Address - Phone:415-715-4576
Mailing Address - Fax:
Practice Address - Street 1:4020 BALBOA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2569
Practice Address - Country:US
Practice Address - Phone:415-668-5998
Practice Address - Fax:415-668-5996
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94023283101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor