MEDICARE: KRISTINA ANITA SANCHEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1043615792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA ANITA SANCHEZ

Provider Business Mailing Address
First Line	:	2209 WILLOW RD
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-5837
Country	:	US
Telephone Number	:	805-739-1512
Fax Number	:	805-739-2855

Provider Business Practice Location Address
First Line	:	1125 E CLARK AVE STE A2
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93455-5192
Country	:	US
Telephone Number	:	805-739-1512
Fax Number	:	805-739-2855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	10/23/2014

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