Healthcare Provider Details

I. General information

NPI: 1487012563
Provider Name (Legal Business Name): CHRISTINA SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA SANCHEZ NP

II. Dates (important events)

Enumeration Date: 02/04/2016
Last Update Date: 05/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4327 GOLDEN CENTER DR
PLACERVILLE CA
95667-6287
US

IV. Provider business mailing address

4327 GOLDEN CENTER DR
PLACERVILLE CA
95667-6287
US

V. Phone/Fax

Practice location:
  • Phone: 530-621-7700
  • Fax: 530-621-7713
Mailing address:
  • Phone: 530-621-7700
  • Fax: 530-621-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95081464
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: