Provider Demographics
NPI:1568892685
Name:RENTFROW, SANDRA DIANE (LPCC 9014)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:DIANE
Last Name:RENTFROW
Suffix:
Gender:F
Credentials:LPCC 9014
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 E AMERICAN AVE.
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93725-9235
Mailing Address - Country:US
Mailing Address - Phone:559-600-4878
Mailing Address - Fax:559-600-7645
Practice Address - Street 1:3333 E AMERICAN AVE.
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93725-9235
Practice Address - Country:US
Practice Address - Phone:559-600-4878
Practice Address - Fax:559-600-7645
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC9014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health