Provider Demographics
NPI:1871682823
Name:SANDERSON, LAURA LAMPERT (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LAMPERT
Last Name:SANDERSON
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17153 ALBERS ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2602
Mailing Address - Country:US
Mailing Address - Phone:818-501-3307
Mailing Address - Fax:818-783-9522
Practice Address - Street 1:15720 VENTURA BLVD
Practice Address - Street 2:507
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2914
Practice Address - Country:US
Practice Address - Phone:818-905-7259
Practice Address - Fax:818-783-9522
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health