Healthcare Provider Details

I. General information

NPI: 1245107689
Provider Name (Legal Business Name): KASSANDRA SANCHEZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 OAK RD STE 100
WALNUT CREEK CA
94597-2078
US

IV. Provider business mailing address

798 LIGHTHOUSE AVE STE 324
MONTEREY CA
93940-1010
US

V. Phone/Fax

Practice location:
  • Phone: 209-877-7844
  • Fax:
Mailing address:
  • Phone: 855-832-6727
  • Fax: 772-675-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: