Provider Demographics
NPI:1679693337
Name:LESSENDEN, SANDRA L
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:LESSENDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:L
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFK
Mailing Address - Street 1:5877 CHABOT CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1643
Mailing Address - Country:US
Mailing Address - Phone:925-933-3338
Mailing Address - Fax:510-654-3299
Practice Address - Street 1:2940 CAMINO DIABLO
Practice Address - Street 2:SUITE 300
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3987
Practice Address - Country:US
Practice Address - Phone:925-933-3338
Practice Address - Fax:510-654-3299
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMK24013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist