MEDICARE: DANIELLE SANDRINO

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
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	1-21-51880	MD

General Provider Information

NPI Number	:	1154826923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE SANDRINO

Provider Business Mailing Address
First Line	:	4221 WILSHIRE BLVD STE 300A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3537
Country	:	US
Telephone Number	:	888-428-3223
Fax Number	:	323-866-1881

Provider Business Practice Location Address
First Line	:	9722 GROFFS MILL DR STE 726
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-6341
Country	:	US
Telephone Number	:	888-428-3223
Fax Number	:	323-866-1881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2018
Last Update Date	:	09/22/2022

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Directions to “ DANIELLE SANDRINO ” Practice Location

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