Provider Demographics
NPI:1780792564
Name:SADAC, ALLAN M (MFT)
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:M
Last Name:SADAC
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 KATELLA AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3399
Mailing Address - Country:US
Mailing Address - Phone:917-798-9912
Mailing Address - Fax:562-684-4122
Practice Address - Street 1:2301 E 28TH ST STE 309
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-2181
Practice Address - Country:US
Practice Address - Phone:916-798-9912
Practice Address - Fax:562-684-4122
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44070106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist