Healthcare Provider Details

I. General information

NPI: 1679491500
Provider Name (Legal Business Name): RUBEN SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HARTLE CT
NAPA CA
94559-4078
US

IV. Provider business mailing address

635 SKYLINE DR
MARTINEZ CA
94553-6040
US

V. Phone/Fax

Practice location:
  • Phone: 866-268-4489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW140085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: