Individual provider Active NPI

Harsimrat Sandhu, M.D.

  • Psychiatry Physician
  • Everett, WA
National Provider Identifier
1710089578
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G78707 Issued in CA
Practice address
3802 Broadway
Suite B
Everett, WA 98201-5032
Phone
(425) 259-6665
Fax
(425) 259-6014
NPI assigned
Sep 2, 2006
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MD00030499 WA
Psychiatry Physician 2084P0800X G78707 CA Primary

Addresses

Primary practice location

3802 Broadway
Suite B
Everett, WA 98201-5032

Mailing address

333 Corporate Dr
Ste 260
Ladera Ranch, CA 92694-2180
Phone (949) 768-2988

Other identifiers 6

IdentifierTypeStateIssuer
FHC 70042FOtherCASANTA CRUZ COUNTY CA MEDI-CAL SITE #
ZZZ91892ZOtherCASANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#
FHC 70044FOtherCASANTA CRUZ COUNTY CA MEDI-CAL SITE #
G78707OtherCAPHYSICIAN AND SURGEON#
ZZZ92069ZOtherCASANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#
ZZZ91891ZOtherCASANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00030499WAMDMental Health Counselor
G78707CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Traditions Psychiatry Group, P.C Psychiatry Past Accepting new patients
Dignity Health Past Accepting new patients
County of Santa Cruz Past Accepting new patients
County of Santa Cruz Past Accepting new patients
Cascade Psychiatric Services, PLLC Past Accepting new patients
Kevin Kinback Psychiatry Past Accepting new patients
Puentes Al Sur Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1710089578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR",
            "address_2": "STE 260",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942180",
            "telephone_number": "949-768-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 BROADWAY",
            "address_2": "SUITE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982015032",
            "telephone_number": "425-259-6665",
            "fax_number": "425-259-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "HARSIMRAT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MD00030499",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G78707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY CA MEDI-CAL SITE #",
            "identifier": "FHC 70042F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY CA MEDI-CAL SITE #",
            "identifier": "FHC 70044F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN AND SURGEON#",
            "identifier": "G78707",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91891Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.