Provider Demographics
NPI:1518232313
Name:SANCHEZ, SERINA NICOLASA (LMFT)
Entity type:Individual
Prefix:
First Name:SERINA
Middle Name:NICOLASA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SERINA
Other - Middle Name:NICOLASA
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:5350 OLD REDWOOD HIGHWAY, SUITE 600
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-1177
Mailing Address - Country:US
Mailing Address - Phone:707-565-1289
Mailing Address - Fax:707-794-7276
Practice Address - Street 1:5350 OLD REDWOOD HIGHWAY, SUITE 600
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-1177
Practice Address - Country:US
Practice Address - Phone:707-565-1289
Practice Address - Fax:707-794-7276
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI14822106H00000X
CA100163106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist