Provider Demographics
NPI:1932335221
Name:SY, HAIHONG DELA SIERRA JR (LPT)
Entity Type:Individual
Prefix:MR
First Name:HAIHONG
Middle Name:DELA SIERRA
Last Name:SY
Suffix:JR
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1621 BILLINGS ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-7413
Mailing Address - Country:US
Mailing Address - Phone:626-646-9011
Mailing Address - Fax:
Practice Address - Street 1:3150 E LOS ANGELES AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3940
Practice Address - Country:US
Practice Address - Phone:805-577-0830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 34612167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician