Active NPI
Harsimrat Sandhu, M.D.
- Psychiatry Physician
- Everett, WA
National Provider Identifier
1710089578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G78707
- 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, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FHC 70042F | Other | CA | SANTA CRUZ COUNTY CA MEDI-CAL SITE # |
| ZZZ91892Z | Other | CA | SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN# |
| FHC 70044F | Other | CA | SANTA CRUZ COUNTY CA MEDI-CAL SITE # |
| G78707 | Other | CA | PHYSICIAN AND SURGEON# |
| ZZZ92069Z | Other | CA | SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN# |
| ZZZ91891Z | Other | CA | SANTA 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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00030499 | WA | MD | Mental Health Counselor |
| G78707 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Specialist
- Everett, WA
- NPI 1841293735
-
- Clinic/Center
- Santa Cruz, CA
- NPI 1659315430
-
dba Watsonville Health Center
- Federally Qualified Health Center (FQHC)
- Watsonville, CA
- NPI 1770709149
-
dba Health Services Agency-Mental Health Division
- Adult Mental Health Clinic/Center
- Watsonville, CA
- NPI 1992849012
-
dba Traditions Behavioral Health
- Psychiatry Physician
- Santa Rosa, CA
- NPI 1083802979
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.