Healthcare Provider Details

I. General information

NPI: 1942496070
Provider Name (Legal Business Name): VIRGINIA L SANCHEZ MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1200 MAPLE ST STE 108
MADERA CA
93637-6330
US

IV. Provider business mailing address

1200 MAPLE ST STE 108
MADERA CA
93637-6330
US

V. Phone/Fax

Practice location:
  • Phone: 559-661-5194
  • Fax: 559-661-5149
Mailing address:
  • Phone: 559-661-5194
  • Fax: 559-661-5149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number53330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: