Provider Demographics
NPI:1851720544
Name:LLAMAS, SANDRA PATRICIA (BA)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:PATRICIA
Last Name:LLAMAS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 WILSHIRE BLVD STE 2200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2632
Mailing Address - Country:US
Mailing Address - Phone:213-382-4400
Mailing Address - Fax:213-382-4494
Practice Address - Street 1:3600 WILSHIRE BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2632
Practice Address - Country:US
Practice Address - Phone:213-382-4400
Practice Address - Fax:213-382-4494
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1851720544Medicaid