Healthcare Provider Details

I. General information

NPI: 1790263671
Provider Name (Legal Business Name): WENDY SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 E 3RD ST STE C
LOS ANGELES CA
90013-1630
US

IV. Provider business mailing address

1307 W 134TH ST SPC 35
GARDENA CA
90247-1941
US

V. Phone/Fax

Practice location:
  • Phone: 213-212-1474
  • Fax:
Mailing address:
  • Phone: 424-558-7499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number123528
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number123528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: