Healthcare Provider Details

I. General information

NPI: 1811834989
Provider Name (Legal Business Name): SANDRA PANOZZO SOLANOT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 26TH ST
SANTA MONICA CA
90403-2202
US

IV. Provider business mailing address

814 26TH ST
SANTA MONICA CA
90403-2202
US

V. Phone/Fax

Practice location:
  • Phone: 818-438-5289
  • Fax:
Mailing address:
  • Phone: 818-438-5289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: