Basic Information
| Provider Information | |||||||||
| NPI: | 1033418835 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANDERSON | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1750 ST. CHARLES AVE. | ||||||||
| Address2: | SUITE 609 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045686004 | ||||||||
| FaxNumber: | 5045686006 | ||||||||
| Practice Location | |||||||||
| Address1: | 1750 ST. CHARLES AVE. | ||||||||
| Address2: | SUITE 609 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045686004 | ||||||||
| FaxNumber: | 5045686006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2011 | ||||||||
| LastUpdateDate: | 10/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | MD.206434 | LA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.