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General NPI Number Information
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NPI Number | 1891719126
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Entity Type | Individual
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Provider Name | SANDRA LEE TODD PHD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 711 E BALL RD
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City | ANAHEIM
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State | CA
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Zip | 92805-5930
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Country | US
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Telephone | 714-254-8473
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Fax |
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Provider Business Mailing Address
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Address Line | 24622 MENDOCINO CT
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5614
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Country | US
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Telephone | 949-360-8806
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY19552
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License Number State | CA
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