Healthcare Provider Details
I. General information
NPI: 1821603770
Provider Name (Legal Business Name): REBECCA SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/08/2020
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3680 E IMPERIAL HWY STE 220
LYNWOOD CA
90262-2663
US
IV. Provider business mailing address
3680 E IMPERIAL HWY STE 220
LYNWOOD CA
90262-2663
US
V. Phone/Fax
- Phone: 323-769-7174
- Fax:
- Phone: 323-769-7174
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: