Healthcare Provider Details

I. General information

NPI: 1952844631
Provider Name (Legal Business Name): ABIGAIL R SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 STOCKER ST STE 205
VIEW PARK CA
90008-5144
US

IV. Provider business mailing address

17925 E KELBY ST
COVINA CA
91722-3236
US

V. Phone/Fax

Practice location:
  • Phone: 702-326-8501
  • Fax:
Mailing address:
  • Phone: 702-326-8501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: