Provider Demographics
NPI:1508593112
Name:JHORN, SAIRA PREET JHUTTY (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAIRA
Middle Name:PREET JHUTTY
Last Name:JHORN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SAIRA
Other - Middle Name:PREET
Other - Last Name:JHUTTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2277 CAMINITO PAJARITO UNIT 171
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-1903
Mailing Address - Country:US
Mailing Address - Phone:858-386-8911
Mailing Address - Fax:
Practice Address - Street 1:2277 CAMINITO PAJARITO UNIT 171
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-1903
Practice Address - Country:US
Practice Address - Phone:858-386-8911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25725103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist