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General NPI Number Information
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NPI Number | 1114931904
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Entity Type | Individual
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Provider Name | DIANA GRACIELA SANCHEZ P.T
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 495 E LOS ANGELES AVE STE 104
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City | SIMI VALLEY
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State | CA
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Zip | 93065-7706
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Country | US
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Telephone | 805-390-6709
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Fax | 805-527-4882
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Provider Business Mailing Address
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Address Line | 495 E LOS ANGELES AVE STE 104
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City | SIMI VALLEY
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State | CA
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Zip | 93065-7706
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Country | US
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Telephone | 805-390-6709
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Fax | 805-527-4882
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT21371
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License Number State | CA
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