MEDICARE: MR. DWAYNE CATRELL SANDERS MS

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
1	106H00000X	Marriage & Family Therapist	AMFT103450	CA
2	106H00000X	Marriage & Family Therapist	AMFT142599	CA

General Provider Information

NPI Number	:	1225172315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DWAYNE CATRELL SANDERS MS

Provider Business Mailing Address
First Line	:	3200 LONG BEACH BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-5062
Country	:	US
Telephone Number	:	562-548-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 LONG BEACH BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-5062
Country	:	US
Telephone Number	:	562-548-6500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/22/2025

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