Provider Demographics
NPI:1306368980
Name:SANO MARRIAGE AND FAMILY THERAPY
Entity Type:Organization
Organization Name:SANO MARRIAGE AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, CSAT, MBAT
Authorized Official - Phone:562-284-7077
Mailing Address - Street 1:6272 E PACIFIC COAST HWY STE D
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-4806
Mailing Address - Country:US
Mailing Address - Phone:562-356-8686
Mailing Address - Fax:
Practice Address - Street 1:6272 E PACIFIC COAST HWY STE D
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-4806
Practice Address - Country:US
Practice Address - Phone:562-356-8686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53733106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty