Basic Information
| Provider Information | |||||||||
| NPI: | 1326170150 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLOGUREN | ||||||||
| FirstName: | SANDRA | ||||||||
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| Credential: | M.F.T.I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 CORPORATE CENTER DR | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | MONTEREY PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917547600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235264076 | ||||||||
| FaxNumber: | 3235264791 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 CORPORATE CENTER DR. | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | MONTEREY PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917547642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235264076 | ||||||||
| FaxNumber: | 3235264791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 05/12/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 48952 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.