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General NPI Number Information
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NPI Number | 1538285234
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Entity Type | Individual
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Provider Name | SANDRA JEAN GREENLAND MFT
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 1722 S LEWIS RD
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City | CAMARILLO
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State | CA
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Zip | 93012-8520
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Country | US
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Telephone | 805-366-4210
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 221052
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City | CARMEL
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State | CA
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Zip | 93922-1052
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Country | US
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Telephone | 821-784-2166
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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 | MFC 38319
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License Number State | CA
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