Provider Demographics
NPI:1528418233
Name:ENGSTROM, ERIN THERESE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:THERESE
Last Name:ENGSTROM
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 1:2825 50TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2310
Mailing Address - Country:US
Mailing Address - Phone:916-703-0233
Mailing Address - Fax:
Practice Address - Street 1:2825 50TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2310
Practice Address - Country:US
Practice Address - Phone:916-703-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32241103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical