Provider Demographics
NPI:1003154030
Name:KAUMAYA, SANDRA KAISER (MFT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:KAISER
Last Name:KAUMAYA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17215 STUDEBAKER RD
Mailing Address - Street 2:STE # 180
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2548
Mailing Address - Country:US
Mailing Address - Phone:562-841-0348
Mailing Address - Fax:564-496-0484
Practice Address - Street 1:17215 STUDEBAKER RD
Practice Address - Street 2:180
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2548
Practice Address - Country:US
Practice Address - Phone:562-841-0348
Practice Address - Fax:564-496-0484
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21540101Y00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor