Provider Demographics
NPI:1295428373
Name:SINGH, SIDNEY ALEXIS
Entity type:Individual
Prefix:MRS
First Name:SIDNEY
Middle Name:ALEXIS
Last Name:SINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SIDNEY
Other - Middle Name:ALEXIS
Other - Last Name:ANDRADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3161 DWIGHT RD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-6456
Mailing Address - Country:US
Mailing Address - Phone:916-427-7141
Mailing Address - Fax:
Practice Address - Street 1:3161 DWIGHT RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-6456
Practice Address - Country:US
Practice Address - Phone:916-427-7141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
CA172V00000X, 390200000X
CA150649106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program