Basic Information
| Provider Information | |||||||||
| NPI: | 1578939039 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILEDAR-LEE | ||||||||
| FirstName: | SHEETAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1850 GATEWAY BLVD #900 | ||||||||
| Address2: | |||||||||
| City: | COCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9258254700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 510 16TH ST | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946121520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103575515 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2015 | ||||||||
| LastUpdateDate: | 05/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 103TC0700X | 33330 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.