Provider Demographics
NPI:1174661490
Name:CHINEN MATHIS, SANDRA SACHIE (LMFT PHD)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SACHIE
Last Name:CHINEN MATHIS
Suffix:
Gender:F
Credentials:LMFT PHD
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:C
Other - Last Name:MATHIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT PHD
Mailing Address - Street 1:PO BOX 23892
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95153-3892
Mailing Address - Country:US
Mailing Address - Phone:408-836-5206
Mailing Address - Fax:408-365-1200
Practice Address - Street 1:830 HILLVIEW COURT
Practice Address - Street 2:SUITE 260
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4550
Practice Address - Country:US
Practice Address - Phone:408-836-5206
Practice Address - Fax:408-365-1200
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31703106H00000X
AZMFT10003106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist