Healthcare Provider Details

I. General information

NPI: 1508264458
Provider Name (Legal Business Name): SHANTI A SANCHEZ LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 BANCROFT RD # 268
WALNUT CREEK CA
94598-1531
US

IV. Provider business mailing address

712 BANCROFT RD # 268
WALNUT CREEK CA
94598-1531
US

V. Phone/Fax

Practice location:
  • Phone: 925-476-4906
  • Fax:
Mailing address:
  • Phone: 925-476-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number131295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: