Healthcare Provider Details

I. General information

NPI: 1770441784
Provider Name (Legal Business Name): MARIA STEPHANIE SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LILIENTHAL LN
REDONDO BEACH CA
90278-4557
US

IV. Provider business mailing address

1100 LILIENTHAL LN
REDONDO BEACH CA
90278-4557
US

V. Phone/Fax

Practice location:
  • Phone: 310-798-8641
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number24016408106182024
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: