Stacey M Sanderson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC39382 Issued in CA

Practice address

600 N Mountain Ave Ste C205G
Upland, CA 91786-4315

Phone

(195) 128-5866

NPI assigned

Nov 18, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Foothills Psychological Services, Inc.

  • Psychologist
  • Upland, CA
  • NPI 1336121888
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1467434951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N MOUNTAIN AVE STE C205G",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864315",
            "telephone_number": "951-285-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MOUNTAIN AVE STE C205G",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864315",
            "telephone_number": "195-128-5866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "954 W Foothill Blvd",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917863782",
            "country_code": "US",
            "telephone_number": "909-946-4222",
            "fax_number": "909-946-8243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "STACEY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC39382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Sanchez
• Larry Anthony Sanchez, SOCIAL WORKER II
• Mariela Brisa Sanchez
• Barbara Lynn Sanders, PSY.D.
• Steven James Sanders, PA-C
• Sonia Sandhu
• George Adel Sandouk
• Belen R Sandoval
• Keren Sandoval
• Victoria Judy Sandoval, MA, AMFT, APCC

• Marriage & Family Therapist in Upland, CA
• Providers in Upland, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.