Provider Demographics
NPI:1568501781
Name:SHIRIKIAN, SYLVIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:
Last Name:SHIRIKIAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1985
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-1985
Mailing Address - Country:US
Mailing Address - Phone:707-687-5245
Mailing Address - Fax:
Practice Address - Street 1:100 E ST
Practice Address - Street 2:SUITE 316
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4608
Practice Address - Country:US
Practice Address - Phone:707-687-5245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21950103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA113585OtherMEDICARE PTAN