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NPI Code Detail

MEDICARE: MS. SANDRA L. MANGAN MFT

MEDICARE:  MS. SANDRA L. MANGAN  MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC 24537CA

General Provider Information

NPI Number : 1063431062
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SANDRA L. MANGAN MFT
Provider Business Mailing Address
First Line : 3938 NORTON AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94602-3943
Country : US
Telephone Number : 510-336-2581
Fax Number : 510-336-2581
Provider Business Practice Location Address
First Line : 516 OAKLAND AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94611-5429
Country : US
Telephone Number : 510-336-2581
Fax Number : 510-336-2581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 07/21/2022

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Directions to “ MS. SANDRA L. MANGAN MFT” Practice Location

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