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General NPI Number Information
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NPI Number | 1538281977
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Entity Type | Individual
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Provider Name | SALLY MANSOUR
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Gender | Female
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 849 FOOTHILL BLVD STE 6
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City | LA CANADA FLINTRIDGE
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State | CA
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Zip | 91011-3368
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Country | US
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Telephone | 818-495-5545
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Fax |
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Provider Business Mailing Address
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Address Line | 3420 LAS PALMAS AVE
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City | GLENDALE
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State | CA
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Zip | 91208-1527
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Country | US
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Telephone | 818-541-7798
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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 | MFC34445
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License Number State | CA
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