Provider Demographics
NPI:1790195311
Name:PEARLMAN, SANFORD (MS, MFT)
Entity type:Individual
Prefix:
First Name:SANFORD
Middle Name:
Last Name:PEARLMAN
Suffix:
Gender:M
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 MILES AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1126
Mailing Address - Country:US
Mailing Address - Phone:773-988-3330
Mailing Address - Fax:
Practice Address - Street 1:7200 BANCROFT AVE STE 125B
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2456
Practice Address - Country:US
Practice Address - Phone:510-365-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist