# SANDRA P BRAVO PSYCHOTHERAPY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831753409
- **Authorized official:** SANDRA PIKER BRAVO LMFT (PRESIDENT)
- **Authorized official phone:** (818) 926-4032

## Contact information

- **Practice address:** 4405 W RIVERSIDE DR STE 205, BURBANK, CA 91505-4050
- **Practice address phone:** (818) 854-0735
- **Mailing address:** 208 S LOUISE ST, GLENDALE, CA 91205-1637
- **Mailing address phone:** (818) 854-0735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/29/2019
- **Last updated:** 04/29/2019