Healthcare Provider Details

I. General information

NPI: 1730804261
Provider Name (Legal Business Name): YESSENIA G SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 11/02/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36618 LASSEN AVE. SUITE A
HURON CA
93234
US

IV. Provider business mailing address

3400 MCCALL AVE STE 104
SELMA CA
93662-2560
US

V. Phone/Fax

Practice location:
  • Phone: 855-343-1057
  • Fax:
Mailing address:
  • Phone: 855-343-1057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT133487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: