Healthcare Provider Details

I. General information

NPI: 1558738948
Provider Name (Legal Business Name): LUCIA SANDRA SANCHEZ MA CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 09/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-3000
  • Fax: 559-353-6950
Mailing address:
  • Phone: 559-353-3000
  • Fax: 559-353-6950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: