Provider Demographics
NPI:1801822036
Name:BROWN, SANDRA ZOE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ZOE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3424 W CARSON ST
Mailing Address - Street 2:STE. 580
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5701
Mailing Address - Country:US
Mailing Address - Phone:310-370-1173
Mailing Address - Fax:
Practice Address - Street 1:3424 W CARSON ST
Practice Address - Street 2:STE. 580
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5701
Practice Address - Country:US
Practice Address - Phone:310-370-1173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPS 9232103TC0700X
CAPS9232103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP9232Medicare ID - Type Unspecified