Healthcare Provider Details

I. General information

NPI: 1720176753
Provider Name (Legal Business Name): MONICA MARIE SANDOWICZ PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 E COLORADO BLVD 8TH FLOOR
PASADENA CA
91101-2044
US

IV. Provider business mailing address

532 E COLORADO BLVD 8TH FLOOR
PASADENA CA
91101-2044
US

V. Phone/Fax

Practice location:
  • Phone: 626-229-3830
  • Fax: 626-564-6082
Mailing address:
  • Phone: 626-229-3830
  • Fax: 626-564-6082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 17112
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: