Provider Demographics
NPI:1851587083
Name:GINSBERG, SANDRA JO (MS, MFT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JO
Last Name:GINSBERG
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:MS
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:GINSBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, MFT
Mailing Address - Street 1:16055 VENTURA BLVD
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2601
Mailing Address - Country:US
Mailing Address - Phone:818-780-7619
Mailing Address - Fax:
Practice Address - Street 1:16055 VENTURA BLVD
Practice Address - Street 2:SUITE 1020
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2601
Practice Address - Country:US
Practice Address - Phone:818-780-7619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32670106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist