Provider Demographics
NPI:1700949138
Name:SANDERS, FELICIA TIOMBE
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:TIOMBE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:TIOMBE
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:211 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2461
Mailing Address - Country:US
Mailing Address - Phone:415-293-7363
Mailing Address - Fax:415-928-6750
Practice Address - Street 1:211 13TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2461
Practice Address - Country:US
Practice Address - Phone:415-293-7363
Practice Address - Fax:415-928-6750
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health