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NPI Code Detail

MEDICARE: CHARVARRIA SANDERS

MEDICARE: CHARVARRIA SANDERS
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 Therapist

General Provider Information

NPI Number : 1205580081
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARVARRIA SANDERS
Provider Business Mailing Address
First Line : 6905 DAKOTA AVE
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91701-5305
Country : US
Telephone Number : 951-229-4248
Fax Number :
Provider Business Practice Location Address
First Line : 15455 SAN FERNANDO MISSION BLVD STE 300
Second Line :
City : MISSION HILLS
State : CA
Zip : 91345-1353
Country : US
Telephone Number : 818-408-9284
Fax Number : 818-847-7830
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2022
Last Update Date : 02/09/2022

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Directions to “ CHARVARRIA SANDERS ” Practice Location

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