Provider Demographics
NPI:1629159439
Name:SARDELLA, ALYSHA RENEE (MFT)
Entity type:Individual
Prefix:MS
First Name:ALYSHA
Middle Name:RENEE
Last Name:SARDELLA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6238 MULBERRY PL
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-7403
Mailing Address - Country:US
Mailing Address - Phone:818-434-4034
Mailing Address - Fax:
Practice Address - Street 1:24509 WALNUT ST STE 102
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2846
Practice Address - Country:US
Practice Address - Phone:818-434-4034
Practice Address - Fax:818-654-1956
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38049106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist