Provider Demographics
NPI:1326170150
Name:SOLOGUREN, SANDRA (MFTI)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:SOLOGUREN
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CORPORATE CENTER DR
Mailing Address - Street 2:SUITE 650
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-7600
Mailing Address - Country:US
Mailing Address - Phone:323-526-4076
Mailing Address - Fax:323-526-4791
Practice Address - Street 1:1000 CORPORATE CENTER DR.
Practice Address - Street 2:SUITE 650
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-7642
Practice Address - Country:US
Practice Address - Phone:323-526-4076
Practice Address - Fax:323-526-4791
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48952106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist