Provider Demographics
NPI:1811284284
Name:WEST, SANDRA R
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:R
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10752 ALICO PASS
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4378
Mailing Address - Country:US
Mailing Address - Phone:785-633-6687
Mailing Address - Fax:
Practice Address - Street 1:3820 GUNN HWY UNIT 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-8720
Practice Address - Country:US
Practice Address - Phone:786-571-4798
Practice Address - Fax:785-232-0160
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
FL247591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker