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NPI Code Detail

MEDICARE: MS. SANDRA MACLEAN FAHEY LMFT

MEDICARE:  MS. SANDRA MACLEAN FAHEY  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC 29135CA

General Provider Information

NPI Number : 1205918836
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SANDRA MACLEAN FAHEY LMFT
Provider Business Mailing Address
First Line : 1465 OAK KNOLL RD
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-4443
Country : US
Telephone Number : 805-934-0437
Fax Number :
Provider Business Practice Location Address
First Line : 500 W FOSTER RD
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-3620
Country : US
Telephone Number : 805-934-6502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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Directions to “ MS. SANDRA MACLEAN FAHEY LMFT” Practice Location

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