Healthcare Provider Details

I. General information

NPI: 1053868893
Provider Name (Legal Business Name): JOANNA SANCHEZ MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 S ANAHEIM BLVD STE 101
ANAHEIM CA
92805-6205
US

IV. Provider business mailing address

1360 S ANAHEIM BLVD STE 101
ANAHEIM CA
92805-6205
US

V. Phone/Fax

Practice location:
  • Phone: 714-948-7641
  • Fax: 714-689-1381
Mailing address:
  • Phone: 714-948-7641
  • Fax: 714-689-1381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number139303
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: