Provider Demographics
NPI:1619169380
Name:EL-SOKKARY, AHMED SABRY (PSYD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:SABRY
Last Name:EL-SOKKARY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 BROADWAY STE 835
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2299
Mailing Address - Country:US
Mailing Address - Phone:415-596-1372
Mailing Address - Fax:510-452-4281
Practice Address - Street 1:1970 BROADWAY STE 835
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2299
Practice Address - Country:US
Practice Address - Phone:415-596-1372
Practice Address - Fax:888-506-6612
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CA19049103TC2200X
CAPSY 19049103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26-0215657Medicaid
CAOPL190490Medicare UPIN