Provider Demographics
NPI:1881915809
Name:SUGARBAKER, RENA (MD)
Entity type:Individual
Prefix:DR
First Name:RENA
Middle Name:
Last Name:SUGARBAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 QUARRY ROAD
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94305
Mailing Address - Country:US
Mailing Address - Phone:650-725-2769
Mailing Address - Fax:650-725-3762
Practice Address - Street 1:401 QUARRY RD
Practice Address - Street 2:DEPT. OF PSYCHIATRY AND BEHAVIORAL SCIENCES
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1419
Practice Address - Country:US
Practice Address - Phone:650-725-2769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1121552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry