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General NPI Number Information
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NPI Number | 1376828822
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Entity Type | Individual
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Provider Name | SANDRA COHN WEISS PHD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 31423 COAST HWY APT 29
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6994
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Country | US
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Telephone | 949-499-5293
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Fax |
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Provider Business Mailing Address
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Address Line | 31423 COAST HIGHWAY #29
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6994
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Country | US
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Telephone | 949-499-5293
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFT6604
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | MFT6604
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License Number State | CA
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