Healthcare Provider Details
I. General information
NPI: 1821851130
Provider Name (Legal Business Name): MARY JEAN SANCHEZ DNP, RN, ED, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2485 SIERRA BELLA DR
CORONA CA
92882
US
IV. Provider business mailing address
2621 GREEN RIVER RD STE 105 #1102
CORONA CA
92882
US
V. Phone/Fax
- Phone: 909-721-9545
- Fax:
- Phone: 909-721-9545
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | 75240 |
| License Number State | CA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1600X |
| Taxonomy | Continuing Education/Staff Development Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WS0121X |
| Taxonomy | Plastic Surgery Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WX0601X |
| Taxonomy | Otorhinolaryngology & Head-Neck Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH1000X |
| Taxonomy | Hospice Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WI0600X |
| Taxonomy | Infection Control Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP2201X |
| Taxonomy | Ambulatory Care Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WX0800X |
| Taxonomy | Orthopedic Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WX1100X |
| Taxonomy | Ophthalmic Registered Nurse |
| License Number | 653111 |
| License Number State | CA |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | 75240 |
| License Number State | CA |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SC1501X |
| Taxonomy | Community Health/Public Health Clinical Nurse Specialist |
| License Number | 75240 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
