Provider Demographics
NPI:1578680468
Name:SANDERS, LAURIE A (LMFT,CADCII-CCS,CAS)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LMFT,CADCII-CCS,CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 BUSINESS CENTER CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-1184
Mailing Address - Country:US
Mailing Address - Phone:805-375-9100
Mailing Address - Fax:805-375-9920
Practice Address - Street 1:1125 BUSINESS CENTER CIR
Practice Address - Street 2:SUITE B
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-1184
Practice Address - Country:US
Practice Address - Phone:805-375-9100
Practice Address - Fax:805-375-9920
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAS2342101Y00000X
CAA3623792101YA0400X
CAMFT30260101YM0800X, 106H00000X
CA357533101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist