Healthcare Provider Details

I. General information

NPI: 1861697880
Provider Name (Legal Business Name): VERONICA SANCHEZ VARELA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 SERENO DR
VALLEJO CA
94589-2441
US

IV. Provider business mailing address

PO BOX 568
PINOLE CA
94564-0568
US

V. Phone/Fax

Practice location:
  • Phone: 707-651-2659
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number26531
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: