Healthcare Provider Details

I. General information

NPI: 1861523599
Provider Name (Legal Business Name): CYNTHIA IRENE SANCHEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 11/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 BALBOA BLVD STE 150
NORTHRIDGE CA
91325-3579
US

IV. Provider business mailing address

4900 SERRANIA AVE
WOODLAND HILLS CA
91364-3301
US

V. Phone/Fax

Practice location:
  • Phone: 818-830-0200
  • Fax: 818-830-0206
Mailing address:
  • Phone: 818-834-7157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS28475
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: