Provider Demographics
NPI:1699806695
Name:SANDRA DAWSON, MA, MFT, MARRIAGE & FAMILY COUNSELING, APC
Entity Type:Organization
Organization Name:SANDRA DAWSON, MA, MFT, MARRIAGE & FAMILY COUNSELING, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT
Authorized Official - Phone:310-291-2201
Mailing Address - Street 1:4077 GLENCOE AVE
Mailing Address - Street 2:#109
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5870
Mailing Address - Country:US
Mailing Address - Phone:310-291-2201
Mailing Address - Fax:432-206-6112
Practice Address - Street 1:4077 GLENCOE AVE
Practice Address - Street 2:#109
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5870
Practice Address - Country:US
Practice Address - Phone:310-291-2201
Practice Address - Fax:432-206-6112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35360106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty