Provider Demographics
NPI:1861018707
Name:ANDERSON, SANDY (MSW)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 CALIFORNIA AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-1841
Mailing Address - Country:US
Mailing Address - Phone:808-622-1618
Mailing Address - Fax:877-759-6943
Practice Address - Street 1:302 CALIFORNIA AVE STE 106
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-1841
Practice Address - Country:US
Practice Address - Phone:808-622-1618
Practice Address - Fax:877-759-6943
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical