Provider Demographics
NPI:1659403624
Name:SKY, CHARLOTTE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:A
Last Name:SKY
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:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:PEBBLE BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93953-0021
Mailing Address - Country:US
Mailing Address - Phone:831-655-1404
Mailing Address - Fax:831-288-2845
Practice Address - Street 1:716 LIGHTHOUSE AVE
Practice Address - Street 2:STE D
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2567
Practice Address - Country:US
Practice Address - Phone:831-655-1404
Practice Address - Fax:831-288-2845
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2018-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 8915103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical