Provider Demographics
NPI:1740556638
Name:ALLEN, SANDY ROMAINE
Entity Type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:ROMAINE
Last Name:ALLEN
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 1:20497 ARDEN PL
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-5752
Mailing Address - Country:US
Mailing Address - Phone:818-359-9495
Mailing Address - Fax:
Practice Address - Street 1:20497 ARDEN PL
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-5752
Practice Address - Country:US
Practice Address - Phone:818-359-9495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT87438106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist