Healthcare Provider Details

I. General information

NPI: 1679436257
Provider Name (Legal Business Name): MICHELLE SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 HOWARD WAY STE 150
COSTA MESA CA
92626-1496
US

IV. Provider business mailing address

PO BOX 20352
FOUNTAIN VALLEY CA
92728-0352
US

V. Phone/Fax

Practice location:
  • Phone: 949-626-9227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: