Healthcare Provider Details

I. General information

NPI: 1366371668
Provider Name (Legal Business Name): ANGIE SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E FOOTHILL BLVD
RIALTO CA
92376-5153
US

IV. Provider business mailing address

425 E FOOTHILL BLVD
RIALTO CA
92376-5153
US

V. Phone/Fax

Practice location:
  • Phone: 909-546-1050
  • Fax:
Mailing address:
  • Phone: 909-546-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: