Provider Demographics
NPI:1265857106
Name:SANDERS, LAURIE D (LMFT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:D
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 HILLCREST BLVD
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9563
Mailing Address - Country:US
Mailing Address - Phone:530-906-0718
Mailing Address - Fax:
Practice Address - Street 1:1500 HILLCREST BLVD
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:CA
Practice Address - Zip Code:95713-9563
Practice Address - Country:US
Practice Address - Phone:530-906-0718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-01
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC49465106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist