Provider Demographics
NPI:1528461787
Name:SANFORD, KRISTI LEA (MA, MS)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LEA
Last Name:SANFORD
Suffix:
Gender:F
Credentials:MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26025 NEWPORT RD STE A478
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7393
Mailing Address - Country:US
Mailing Address - Phone:951-992-9633
Mailing Address - Fax:
Practice Address - Street 1:26025 NEWPORT RD STE A478
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-7393
Practice Address - Country:US
Practice Address - Phone:951-992-9633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116473106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist