Provider Demographics
NPI:1598220790
Name:MCLAREN, SANDRA ANNE (DDS LMFT)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ANNE
Last Name:MCLAREN
Suffix:
Gender:F
Credentials:DDS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 PACIFIC AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1402
Mailing Address - Country:US
Mailing Address - Phone:310-882-8272
Mailing Address - Fax:
Practice Address - Street 1:155 5TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103
Practice Address - Country:US
Practice Address - Phone:415-351-7163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108452101YM0800X
CA29852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health