Provider Demographics
NPI:1548754351
Name:MILSTEIN-OSTROM, SANDRA RAQUEL (LMFT, APCC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:RAQUEL
Last Name:MILSTEIN-OSTROM
Suffix:
Gender:F
Credentials:LMFT, APCC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:ROSENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9539 BAYAMON RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2873
Mailing Address - Country:US
Mailing Address - Phone:619-922-1012
Mailing Address - Fax:
Practice Address - Street 1:9921 CARMEL MOUNTAIN RD # 194
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2813
Practice Address - Country:US
Practice Address - Phone:858-215-1601
Practice Address - Fax:858-223-7822
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA121126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health