Basic Information
| Provider Information | |||||||||
| NPI: | 1831236074 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHERPA | ||||||||
| FirstName: | NAMGYAL | ||||||||
| MiddleName: | WANGCHUK | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MFTI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7909 E BAUER RD | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928082204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513585862 | ||||||||
| FaxNumber: | 9516873478 | ||||||||
| Practice Location | |||||||||
| Address1: | 9707 MAGNOLIA AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925033609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513585962 | ||||||||
| FaxNumber: | 9516783478 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | IMF51951 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.