Organization · Type 2 NPI

Sud Specialty Group - Ca

Addiction Medicine (Psychiatry & Neurology) Physician · Santa Clara, CA

NPI number 1972138238 Active

Practice location

4633 Old Ironsides Dr Ste 304
Santa Clara, CA 95054-1846

Call (323) 205-7088 Map

Fax (866) 277-9071

Mailing address

PO Box 746877
Atlanta, GA 30374-6877

Other practice locations

  • 5201 Great America Pkwy Ste 320, Santa Clara, CA 95054-1140 · (323) 205-7088

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Addiction (Substance Use Disorder) Psychologist 103TA0400XNone listed
Cognitive & Behavioral Psychologist 103TB0200XNone listed
Counseling Psychologist 103TC1900XNone listed
Clinical Social Worker 1041C0700XNone listed
Marriage & Family Therapist 106H00000XNone listed
Case Manager/Care Coordinator 171M00000XNone listed
Addiction Medicine (Family Medicine) Physician 207QA0401XNone listed
Addiction Medicine (Internal Medicine) Physician 207RA0401XNone listed
Addiction Medicine (Psychiatry & Neurology) Physician Primary 2084A0401XNone listed
Psychiatry Physician 2084P0800XNone listed
Psychiatric/Mental Health Nurse Practitioner 363LP0808XNone listed

Addiction Medicine (Psychiatry & Neurology) Physician: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

13 other providers at this address

About NPI 1972138238

Sud Specialty Group - Ca's National Provider Identifier is 1972138238, issued on Mar 6, 2020. The primary taxonomy on file is Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X), and the practice location is in Santa Clara, CA. The record was last updated on Sep 17, 2026.