Provider Demographics
NPI:1578712105
Name:CHANG, SAND C (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAND
Middle Name:C
Last Name:CHANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SAND
Other - Middle Name:CHIH-ANN
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:625 MARKET ST FL 15
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-3316
Mailing Address - Country:US
Mailing Address - Phone:415-360-3833
Mailing Address - Fax:
Practice Address - Street 1:625 MARKET ST FL 15
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105
Practice Address - Country:US
Practice Address - Phone:415-360-3833
Practice Address - Fax:929-529-6277
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22098103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical