Provider Demographics
NPI:1780859033
Name:PERROTTA-LUTCHER, SANDRA (MFT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:PERROTTA-LUTCHER
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 1:595 EAST COLORADO BLVD.
Mailing Address - Street 2:SUITE719
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2039
Mailing Address - Country:US
Mailing Address - Phone:818-384-3116
Mailing Address - Fax:
Practice Address - Street 1:595 EAST COLORADO BLVD.
Practice Address - Street 2:SUITE719
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2039
Practice Address - Country:US
Practice Address - Phone:818-384-3116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36491106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist