Healthcare Provider Details

I. General information

NPI: 1700727070
Provider Name (Legal Business Name): MRS. LAUREL-ANNE SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. LAUREL-ANNE CARLSON

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S EMERALD AVE
MODESTO CA
95351-1901
US

IV. Provider business mailing address

120 S EMERALD AVE
MODESTO CA
95351-1901
US

V. Phone/Fax

Practice location:
  • Phone: 209-574-8112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: