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General NPI Number Information
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NPI Number | 1275313322
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Entity Type | Individual
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Provider Name | MISS SABRENA RAKEL EDWARDS
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Gender | Female
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 2650 E FOOTHILL BLVD
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City | PASADENA
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State | CA
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Zip | 91107-3439
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Country | US
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Telephone | 626-577-2261
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Fax |
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Provider Business Mailing Address
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Address Line | 19018 HILLFORD AVE
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City | CARSON
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State | CA
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Zip | 90746-2652
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Country | US
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Telephone | 310-753-1896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 142679
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License Number State | CA
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