Provider Demographics
NPI:1326270794
Name:SANDS, GENA (MA)
Entity Type:Individual
Prefix:
First Name:GENA
Middle Name:
Last Name:SANDS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 REBILD DR
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2218
Mailing Address - Country:US
Mailing Address - Phone:805-698-7769
Mailing Address - Fax:
Practice Address - Street 1:2795 EAST HIGHWAY 246
Practice Address - Street 2:
Practice Address - City:SANTA YNEZ
Practice Address - State:CA
Practice Address - Zip Code:93460
Practice Address - Country:US
Practice Address - Phone:805-688-6487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)