Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 102L00000X | Psychologist | PSY16487 | CA |
Y | 103T00000X | Psychologist | PSY16487 | CA |
NPI | 1003969197 |
---|---|
Provider Name | Dr. Sandra Michelle Hardy |
First Address | Lakewood, CA 90712-1622 |
Second Address | Long Beach, CA 90807-3529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2007 |
Last Update Date | 11/06/2020 |