Provider Demographics
NPI:1770662868
Name:BOYCE, SANDRA JILL (MFT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:JILL
Last Name:BOYCE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:JILL
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:138 B AVE
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-2442
Mailing Address - Country:US
Mailing Address - Phone:619-437-6209
Mailing Address - Fax:619-435-2063
Practice Address - Street 1:138 B AVE
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-2442
Practice Address - Country:US
Practice Address - Phone:619-437-6209
Practice Address - Fax:619-435-2063
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28281106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist