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NPI Code Detail

MEDICARE: MR. DWAYNE CATRELL SANDERS

MEDICARE:  MR. DWAYNE CATRELL 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 TherapistAMFT142599CA
2106H00000XMarriage & Family TherapistAMFT103450CA

General Provider Information

NPI Number : 1225172315
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DWAYNE CATRELL SANDERS
Provider Business Mailing Address
First Line : 1774 ZONAL AVE BLDG B
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1064
Country : US
Telephone Number : 310-221-6336
Fax Number :
Provider Business Practice Location Address
First Line : 1774 ZONAL AVE BLDG B
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1064
Country : US
Telephone Number : 310-221-6336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 05/04/2026

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Directions to “ MR. DWAYNE CATRELL SANDERS ” Practice Location

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