Provider Demographics
NPI:1821118852
Name:SANSAC, CRISTINA POMO (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:POMO
Last Name:SANSAC
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10870 SW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2424
Mailing Address - Country:US
Mailing Address - Phone:305-283-7813
Mailing Address - Fax:305-808-3407
Practice Address - Street 1:9555 N KENDALL DR
Practice Address - Street 2:SUITE 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1978
Practice Address - Country:US
Practice Address - Phone:305-480-1014
Practice Address - Fax:305-270-6325
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLCSW 71681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical