Provider Demographics
NPI:1477709566
Name:COX, SANDRA JOAN (LMFT/LSP)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JOAN
Last Name:COX
Suffix:
Gender:F
Credentials:LMFT/LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38557 NASTURTIUM WAY
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211
Mailing Address - Country:US
Mailing Address - Phone:760-345-9002
Mailing Address - Fax:760-345-0020
Practice Address - Street 1:77564 COUNTRY CLUB DR
Practice Address - Street 2:SUITE 410
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211
Practice Address - Country:US
Practice Address - Phone:760-345-9002
Practice Address - Fax:760-345-0020
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 24856106H00000X
CALSP 002080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5P0020100OtherBLUE SHIELD PIN #
CA248560OtherBLUE SHIELD PIN #