Healthcare Provider Details

I. General information

NPI: 1447985056
Provider Name (Legal Business Name): EMMA J SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9325 SKY PARK CT STE 310
SAN DIEGO CA
92123-4368
US

IV. Provider business mailing address

1830 NOBLE ST
LEMON GROVE CA
91945-3728
US

V. Phone/Fax

Practice location:
  • Phone: 877-567-4265
  • Fax:
Mailing address:
  • Phone: 619-319-8299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number01100696
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: