Provider Demographics
NPI:1982803169
Name:SAKHAI, KAMBIZ (PSYD)
Entity Type:Individual
Prefix:
First Name:KAMBIZ
Middle Name:
Last Name:SAKHAI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W JOAQUIN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3667
Mailing Address - Country:US
Mailing Address - Phone:510-689-6236
Mailing Address - Fax:510-373-6282
Practice Address - Street 1:303 W JOAQUIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3667
Practice Address - Country:US
Practice Address - Phone:510-689-6236
Practice Address - Fax:510-373-6282
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25035103TC0700X
CAPSY25035103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical