Provider Demographics
NPI:1225622806
Name:SANGALANG, BREANNE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:BREANNE
Middle Name:
Last Name:SANGALANG
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5743 CORSA AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-6441
Mailing Address - Country:US
Mailing Address - Phone:805-390-4386
Mailing Address - Fax:
Practice Address - Street 1:5743 CORSA AVE STE 112
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-6441
Practice Address - Country:US
Practice Address - Phone:805-390-4386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123017106H00000X
CA138136106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist