Provider Demographics
NPI:1558531673
Name:SANFORD, LINDA (MA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SANFORD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 H ST
Mailing Address - Street 2:ROOM 202
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-4021
Mailing Address - Country:US
Mailing Address - Phone:707-464-7215
Mailing Address - Fax:
Practice Address - Street 1:450 H ST
Practice Address - Street 2:ROOM 202
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-4021
Practice Address - Country:US
Practice Address - Phone:707-464-7215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator