Healthcare Provider Details

I. General information

NPI: 1801725007
Provider Name (Legal Business Name): SANDRA FERNANDES CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANDRINHA CRUZ

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 E COLORADO BLVD STE 180&2ND
PASADENA CA
91101-6143
US

IV. Provider business mailing address

9395 RANDALL AVE
LA HABRA CA
90631-3441
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax: 929-596-7897
Mailing address:
  • Phone: 562-640-3364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFT162256
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT162256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: