Provider Demographics
NPI:1497495436
Name:WOLFSON-SANGER, ABBIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ABBIE
Middle Name:
Last Name:WOLFSON-SANGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ABBIE
Other - Middle Name:
Other - Last Name:WOLFSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:690 E GREEN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2197
Mailing Address - Country:US
Mailing Address - Phone:650-799-9521
Mailing Address - Fax:
Practice Address - Street 1:690 E GREEN ST STE 202
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2197
Practice Address - Country:US
Practice Address - Phone:424-625-9986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28282103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical