Provider Demographics
NPI:1457793408
Name:GILCREST, SANDY SCHULTE (EDD)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:SCHULTE
Last Name:GILCREST
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:MS
Other - First Name:SANDY
Other - Middle Name:SCHULTE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21633 AVENUE 24
Mailing Address - Street 2:
Mailing Address - City:CHOWCHILLA
Mailing Address - State:CA
Mailing Address - Zip Code:93610-9650
Mailing Address - Country:US
Mailing Address - Phone:559-665-6100
Mailing Address - Fax:559-665-6147
Practice Address - Street 1:21633 AVENUE 24
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-9650
Practice Address - Country:US
Practice Address - Phone:559-665-6100
Practice Address - Fax:559-665-6147
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 19876103TF0200X
CAPSY19876103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic