Active NPI
Sally Saemee Sun
- Psychiatric Pharmacist
- San Rafael, CA
National Provider Identifier
1295305613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 85215
- Practice address
- 111 Smith Ranch Rd
Department of Psychiatry
San Rafael, CA 94903 - Phone
- (415) 491-3000
- NPI assigned
- Jun 28, 2021
- Reactivated
- Nov 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 85215 | CA | Primary |
Addresses
Primary practice location
111 Smith Ranch Rd
Department of Psychiatry
San Rafael, CA 94903
Mailing address
111 Smith Ranch Rd
Department of Psychiatry
San Rafael, CA 94903
Phone (415) 491-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85215 | CA | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702598400000",
"number": "1295305613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 SMITH RANCH RD",
"address_2": "DEPARTMENT OF PSYCHIATRY",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "94903",
"telephone_number": "415-491-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 SMITH RANCH RD",
"address_2": "DEPARTMENT OF PSYCHIATRY",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "94903",
"telephone_number": "415-491-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUN",
"first_name": "SALLY",
"middle_name": "SAEMEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-28",
"last_updated": "2023-12-15",
"certification_date": "2023-12-15",
"deactivation_date": "2021-09-20",
"reactivation_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "CA",
"license": "85215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.