Provider Demographics
NPI:1609067610
Name:GASPAR, SANDRA
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:GASPAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:GASPAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFC
Mailing Address - Street 1:401 ROLAND WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621
Mailing Address - Country:US
Mailing Address - Phone:510-746-2800
Mailing Address - Fax:510-746-2810
Practice Address - Street 1:410 ROLAND WAY. SUITE 100
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621
Practice Address - Country:US
Practice Address - Phone:510-746-2800
Practice Address - Fax:510-746-2810
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52795106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist