MEDICARE: MS. SANDRA MARIE PAOLINI M.A.

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	44530	CA

General Provider Information

NPI Number	:	1366572083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA MARIE PAOLINI M.A.

Provider Business Mailing Address
First Line	:	1630 N MAIN ST # 298
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-4609
Country	:	US
Telephone Number	:	925-932-3229
Fax Number	:	925-457-7230

Provider Business Practice Location Address
First Line	:	1340 ARNOLD DR STE 200
Second Line	:
City	:	MARTINEZ
State	:	CA
Zip	:	94553-4189
Country	:	US
Telephone Number	:	925-457-7230
Fax Number	:	925-482-0576

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	02/26/2024

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