Provider Demographics
NPI:1487782405
Name:NUNEZ, SANDRA YEMILETH (M A, IMFT)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:YEMILETH
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:M A, IMFT
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:YEMILETH
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M A, IMFT
Mailing Address - Street 1:2500 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3464
Mailing Address - Country:US
Mailing Address - Phone:626-564-1613
Mailing Address - Fax:
Practice Address - Street 1:2500 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3464
Practice Address - Country:US
Practice Address - Phone:626-564-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48143106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist