Healthcare Provider Details

I. General information

NPI: 1760328017
Provider Name (Legal Business Name): GINA SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W SAN BERNARDINO RD
COVINA CA
91722-3621
US

IV. Provider business mailing address

217 S AVE 51
HIGHLAND PARK CA
90042-4501
US

V. Phone/Fax

Practice location:
  • Phone: 626-541-0120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: