Provider Demographics
NPI:1699068320
Name:MARSHALL, SAUNDRA (MA)
Entity type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9312
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-9312
Mailing Address - Country:US
Mailing Address - Phone:925-432-9668
Mailing Address - Fax:
Practice Address - Street 1:1333 WILLOW PASS RD
Practice Address - Street 2:STE. 102
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-7930
Practice Address - Country:US
Practice Address - Phone:925-825-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 61993101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health