Healthcare Provider Details

I. General information

NPI: 1417411463
Provider Name (Legal Business Name): KRISTINA NICOLE SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3281 E GUASTI RD # 713
ONTARIO CA
91761-7622
US

IV. Provider business mailing address

6635 FLORENCE AVE STE 101
BELL GARDENS CA
90201-4968
US

V. Phone/Fax

Practice location:
  • Phone: 909-600-8134
  • Fax: 909-614-8136
Mailing address:
  • Phone: 323-647-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number101721
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: