Provider Demographics
NPI:1477857829
Name:WEBBER-SANDRES, PAMELA L (M-RAS, CCDS, MFTI)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:L
Last Name:WEBBER-SANDRES
Suffix:
Gender:F
Credentials:M-RAS, CCDS, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-3033
Mailing Address - Country:US
Mailing Address - Phone:323-373-2444
Mailing Address - Fax:323-373-2442
Practice Address - Street 1:3031 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-3033
Practice Address - Country:US
Practice Address - Phone:323-373-2444
Practice Address - Fax:323-373-2442
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health