Healthcare Provider Details

I. General information

NPI: 1457635542
Provider Name (Legal Business Name): SAUNDRE ALLEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 CENTER DR STE 600
LOS ANGELES CA
90045-1540
US

IV. Provider business mailing address

PO BOX 130
CULVER CITY CA
90232-0130
US

V. Phone/Fax

Practice location:
  • Phone: 510-969-2951
  • Fax:
Mailing address:
  • Phone: 510-969-2951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number84933
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13310-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: