Provider Demographics
NPI:1760693147
Name:WASHINGTON, GUY EDWARD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:EDWARD
Last Name:WASHINGTON
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 1:2435 ALBATROSS WAY STE 118
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-2879
Mailing Address - Country:US
Mailing Address - Phone:916-925-1459
Mailing Address - Fax:916-925-1653
Practice Address - Street 1:2435 ALBATROSS WAY STE 118
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-2879
Practice Address - Country:US
Practice Address - Phone:916-925-1459
Practice Address - Fax:916-925-1653
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23211103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical