Basic Information
| Provider Information | |||||||||
| NPI: | 1609994698 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERRERA | ||||||||
| FirstName: | SANDRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1434 N CALIFORNIA AVE | ||||||||
| Address2: | APT. 9 | ||||||||
| City: | LA PUENTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917441025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6265594428 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 CORPORATE CENTER DR | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | MONTEREY PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235264016 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2007 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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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 | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 101YM0800X | ASW83428 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.