Healthcare Provider Details

I. General information

NPI: 1336515634
Provider Name (Legal Business Name): MARISA SANCHEZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 N 44TH STREET 104
PHOENIX AZ
85018
US

IV. Provider business mailing address

3303 N 44TH STREET 104
PHOENIX AZ
85018
US

V. Phone/Fax

Practice location:
  • Phone: 480-478-0444
  • Fax: 602-854-7422
Mailing address:
  • Phone: 480-478-0444
  • Fax: 602-854-7422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY-006116
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number20-3257211
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: