Provider Demographics
NPI:1790062214
Name:LAMBERT, SANDRA (MFC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 816
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-0816
Mailing Address - Country:US
Mailing Address - Phone:626-674-1196
Mailing Address - Fax:
Practice Address - Street 1:157 N GLENDORA AVE
Practice Address - Street 2:#215
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-3383
Practice Address - Country:US
Practice Address - Phone:626-674-1196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41836106H00000X
AZLPC1420106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist