Healthcare Provider Details

I. General information

NPI: 1265500193
Provider Name (Legal Business Name): BORIS E SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 39TH ST
RICHMOND CA
94805-2212
US

IV. Provider business mailing address

PO BOX 7086
COTATI CA
94931-7086
US

V. Phone/Fax

Practice location:
  • Phone: 510-412-5930
  • Fax: 510-412-0567
Mailing address:
  • Phone: 707-703-2512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number89431
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number44695
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number62230
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: