Provider Demographics
NPI:1447452370
Name:RANDALL, SYLVIA ADKINS (PHD)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:ADKINS
Last Name:RANDALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SYLVIA
Other - Middle Name:DOROTHY
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3872 DUNCAN PL
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-4548
Mailing Address - Country:US
Mailing Address - Phone:650-494-6402
Mailing Address - Fax:650-856-8927
Practice Address - Street 1:3872 DUNCAN PL
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-4548
Practice Address - Country:US
Practice Address - Phone:650-494-6402
Practice Address - Fax:650-856-8927
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 3126103TP2701X
ORPSY 1735103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy