Doctor Name: | SANDRA SUE DALTON |
NPI Number: | 1184843534 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CATC |
License Number: | 061256 |
Business Practice Address: | 11015 Bloomfield Ave Santa Fe Springs, CA - 906704601 |
Business Phone Number: | 5629062676 |
Business Fax Number: | 5629062681 |
Mailing Address: | 3747 Princeton St, LOS ANGELES |
State: | CA |
Postal Code: | 900231821 |
Phone Number: | 3232703012 |
Fax Number: | |
NPI Enumeration Date: | 04/24/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 061256 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |