Healthcare Provider Details

I. General information

NPI: 1568371243
Provider Name (Legal Business Name): JAMES WILLIAM SANFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 51ST ST NE # 1
CEDAR RAPIDS IA
52402-2466
US

IV. Provider business mailing address

1620 PARK TOWNE PL NE APT 10
CEDAR RAPIDS IA
52402-6431
US

V. Phone/Fax

Practice location:
  • Phone: 319-214-0350
  • Fax:
Mailing address:
  • Phone: 319-538-1642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number138684
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: