Healthcare Provider Details

I. General information

NPI: 1164938197
Provider Name (Legal Business Name): RUBI JAIME SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 05/07/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6840 VIA DEL ORO STE 210
SAN JOSE CA
95119-1372
US

IV. Provider business mailing address

1214 LEEWARD CT
SAN JOSE CA
95122-1039
US

V. Phone/Fax

Practice location:
  • Phone: 408-248-2228
  • Fax: 408-754-0450
Mailing address:
  • Phone: 408-910-6461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number127569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: