Provider Demographics
NPI:1881835882
Name:SANDE, VEDA J (MFT)
Entity Type:Individual
Prefix:MS
First Name:VEDA
Middle Name:J
Last Name:SANDE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16944 VENTURA BLVD
Mailing Address - Street 2:SUITE#24
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4144
Mailing Address - Country:US
Mailing Address - Phone:818-981-3191
Mailing Address - Fax:
Practice Address - Street 1:16944 VENTURA BLVD
Practice Address - Street 2:SUITE#24
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4144
Practice Address - Country:US
Practice Address - Phone:818-981-3191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32423106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist