Provider Demographics
NPI:1982688362
Name:SIERRA, ANA MARIA (PHD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:SIERRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANA
Other - Middle Name:MARIA
Other - Last Name:SIERRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2522 N PROCTOR ST
Mailing Address - Street 2:#355
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5338
Mailing Address - Country:US
Mailing Address - Phone:253-686-5184
Mailing Address - Fax:844-965-9701
Practice Address - Street 1:2205 N 30TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3320
Practice Address - Country:US
Practice Address - Phone:253-686-5184
Practice Address - Fax:844-965-9701
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002251103TC0700X, 103TC2200X
103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty