Provider Demographics
NPI:1669773883
Name:SUNDEL, SANDRA D (PHD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:D
Last Name:SUNDEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 KALAMIS WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-7411
Mailing Address - Country:US
Mailing Address - Phone:954-599-5098
Mailing Address - Fax:760-216-6826
Practice Address - Street 1:4911 KALAMIS WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-7411
Practice Address - Country:US
Practice Address - Phone:954-599-5098
Practice Address - Fax:760-216-6826
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW114591041C0700X
FLSW44321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical