Healthcare Provider Details

I. General information

NPI: 1497872584
Provider Name (Legal Business Name): SANDRA SINZ DUONG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANDRA LYNN SINZ LCSW

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1774 COLORADO LN
DAVIS CA
95616-6661
US

IV. Provider business mailing address

1774 COLORADO LN
DAVIS CA
95616-6661
US

V. Phone/Fax

Practice location:
  • Phone: 530-753-9683
  • Fax: 530-231-0122
Mailing address:
  • Phone: 530-753-9683
  • Fax: 530-231-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 17934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: