Healthcare Provider Details

I. General information

NPI: 1154517811
Provider Name (Legal Business Name): HORACIO SANCHEZ ACSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HORACIO SANCHEZ-AZPEITIA

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E CHAPMAN AVE #203
FULLERTON CA
92831-3839
US

IV. Provider business mailing address

PO BOX 919 CRITTENTON SERVICES
FULLERTON CA
92836-0919
US

V. Phone/Fax

Practice location:
  • Phone: 714-680-8268
  • Fax:
Mailing address:
  • Phone: 714-680-8268
  • Fax: 714-680-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number79263
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: