Provider Demographics
NPI:1578636643
Name:EDWARDS, SAUNDRA JEAN (MFT)
Entity Type:Individual
Prefix:MS
First Name:SAUNDRA
Middle Name:JEAN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 DOWNEY AVE
Mailing Address - Street 2:UNIT 268
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-4597
Mailing Address - Country:US
Mailing Address - Phone:562-531-6484
Mailing Address - Fax:
Practice Address - Street 1:5777 W CENTURY BLVD
Practice Address - Street 2:SUITE 910
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-5600
Practice Address - Country:US
Practice Address - Phone:323-365-1856
Practice Address - Fax:323-586-3988
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 36706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist