# SYDNEY SKINNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073086344
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | 55553 | CA | Yes |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 01/09/2019
- **Last updated:** 01/09/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 136A00000X | NON MEDICARE | CA |
| 01 | — | 55553 | NON MEDICARE | CA |