Provider Demographics
NPI:1346903077
Name:WOHALI, SANDRA DAWN (MSW, ASW, MAT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:DAWN
Last Name:WOHALI
Suffix:
Gender:F
Credentials:MSW, ASW, MAT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:WILBANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1381 ROSAL LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-2635
Mailing Address - Country:US
Mailing Address - Phone:925-383-3396
Mailing Address - Fax:
Practice Address - Street 1:1420 WILLOW PASS RD # 200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5823
Practice Address - Country:US
Practice Address - Phone:925-646-5480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1023071041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical