Provider Demographics
NPI:1346579307
Name:SANDERS, VICTORIA MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:MARIE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 W SHAW AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3401
Mailing Address - Country:US
Mailing Address - Phone:559-573-4194
Mailing Address - Fax:559-224-4288
Practice Address - Street 1:2350 W SHAW AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3401
Practice Address - Country:US
Practice Address - Phone:559-573-4194
Practice Address - Fax:559-224-4288
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52610106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist