MEDICARE: SANDRA FERNANDES CRUZ

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	101YM0800X	Mental Health Counselor	LMFT162256	CA
2	221700000X	Art Therapist
3	106H00000X	Marriage & Family Therapist	LMFT162256	CA

General Provider Information

NPI Number	:	1801725007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA FERNANDES CRUZ

Provider Business Mailing Address
First Line	:	9395 RANDALL AVE
Second Line	:
City	:	LA HABRA
State	:	CA
Zip	:	90631-3441
Country	:	US
Telephone Number	:	562-640-3364
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 E COLORADO BLVD STE 180&2ND
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-6143
Country	:	US
Telephone Number	:	646-941-7645
Fax Number	:	929-596-7897

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

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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Directions to “ SANDRA FERNANDES CRUZ ” Practice Location

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