Basic Information
| Provider Information | |||||||||
| NPI: | 1881915809 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUGARBAKER | ||||||||
| FirstName: | RENA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 QUARRY ROAD | ||||||||
| Address2: | DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507252769 | ||||||||
| FaxNumber: | 6507253762 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 QUARRY RD | ||||||||
| Address2: | DEPT. OF PSYCHIATRY AND BEHAVIORAL SCIENCES | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507252769 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2010 | ||||||||
| LastUpdateDate: | 06/14/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 112155 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.