Healthcare Provider Details

I. General information

NPI: 1194101162
Provider Name (Legal Business Name): SANYA LITCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2015
Last Update Date: 10/03/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44447 10TH ST W
LANCASTER CA
93534-3324
US

IV. Provider business mailing address

44447 10TH ST W
LANCASTER CA
93534-3324
US

V. Phone/Fax

Practice location:
  • Phone: 661-450-8685
  • Fax:
Mailing address:
  • Phone: 661-450-8685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number118126
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number14702
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: