=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891027314
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SANDY ALCANTAR LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2010
-----------------------------------------------------
Last Update Date | 02/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1499 HUNTINGTON DR STE 100
-----------------------------------------------------
City | SOUTH PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91030-5443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-403-4370
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1801 W VALLEY BLVD STE 201
-----------------------------------------------------
City | ALHAMBRA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91803-2300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-313-0176
-----------------------------------------------------
Fax | 626-988-0288
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCSW83466
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------