Provider Demographics
NPI:1740567155
Name:INABA, SANDRA SACHI (MFT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:SACHI
Last Name:INABA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 SAN CARLOS DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3138
Mailing Address - Country:US
Mailing Address - Phone:925-858-2334
Mailing Address - Fax:
Practice Address - Street 1:1445 JOEL CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-3041
Practice Address - Country:US
Practice Address - Phone:925-858-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41273106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist