Sahli A Cavallaro, PHD

Individual provider Active NPI Clinical Psychologist · Beale Afb, CA

NPI 1841361565 · NPPES record last updated Jan 9, 2023

Key facts

NPI
1841361565
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PSY25771 (CA)
Practice address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Phone
(518) 527-1040
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY25771CAMDClinical Psychologist
011475-2NYMDClinical Psychologist
011475NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Psychological Associates Clinical Past Accepting new patients
Northeast Psychological Associates PLLC Past
since Jul 1, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 011475-2 NY
Clinical Psychologist 103TC0700X PSY25771 CA Yes

Addresses

Primary practice location

15301 Warren Shingle Rd
Beale Afb, CA 95903-1907

Mailing address

15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Phone (518) 527-1040

Other providers in Beale Afb, CA

All providers in Beale Afb, CA · Clinical Psychologist in California

Sources for this page

Verify at the official NPI Registry.