Provider Demographics
NPI:1780692855
Name:SANDERS, JAMES JUDE (LMFT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JUDE
Last Name:SANDERS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RUE FONTAINBLEAU
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5926
Mailing Address - Country:US
Mailing Address - Phone:949-636-7529
Mailing Address - Fax:949-264-6322
Practice Address - Street 1:2721 E COAST HWY STE 209
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2131
Practice Address - Country:US
Practice Address - Phone:949-636-7529
Practice Address - Fax:949-264-6322
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40061106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA86-1106651OtherTIN