Healthcare Provider Details

I. General information

NPI: 1801822036
Provider Name (Legal Business Name): SANDRA ZOE BROWN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3424 W CARSON ST STE. 580
TORRANCE CA
90503-5701
US

IV. Provider business mailing address

3424 W CARSON ST STE. 580
TORRANCE CA
90503-5701
US

V. Phone/Fax

Practice location:
  • Phone: 310-370-1173
  • Fax:
Mailing address:
  • Phone: 310-370-1173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS 9232
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS9232
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPS9232
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: