Provider Demographics
NPI:1366676199
Name:ISLANDS, SANDY (MS, MA, PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:
Last Name:ISLANDS
Suffix:
Gender:F
Credentials:MS, MA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38934 DESERT GREENS DR E
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-1417
Mailing Address - Country:US
Mailing Address - Phone:760-565-3522
Mailing Address - Fax:760-496-5872
Practice Address - Street 1:38934 DESERT GREENS DR E
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-1417
Practice Address - Country:US
Practice Address - Phone:760-565-3522
Practice Address - Fax:760-496-5872
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC194101YM0800X
CA1453101YP2500X, 101YM0800X
HICSAC 1454-09101YA0400X
FLLMHC 1298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XOtherCOUNSELOR MENTAL HEALTH
CA2036K8P1Medicaid