Provider Demographics
NPI:1689289068
Name:SANDERS, BOBBYE JO
Entity Type:Individual
Prefix:
First Name:BOBBYE
Middle Name:JO
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 N MONTEREY ST APT D
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-2516
Mailing Address - Country:US
Mailing Address - Phone:928-276-1601
Mailing Address - Fax:
Practice Address - Street 1:308 N MONTEREY ST APT D
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-2516
Practice Address - Country:US
Practice Address - Phone:928-276-1601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist