Provider Demographics
NPI:1568661734
Name:KAUFMAN, SANDY H (MFT)
Entity Type:Individual
Prefix:MR
First Name:SANDY
Middle Name:H
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11684 VENTURA BLVD # 954
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2699
Mailing Address - Country:US
Mailing Address - Phone:818-761-4200
Mailing Address - Fax:818-766-3034
Practice Address - Street 1:11712 MOORPARK ST STE 108
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2156
Practice Address - Country:US
Practice Address - Phone:818-761-4200
Practice Address - Fax:818-766-3034
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34914106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist