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General NPI Number Information
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NPI Number | 1609419316
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Entity Type | Individual
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Provider Name | JESSICA SANCHEZ MSW
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Gender | Female
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 06/17/2023
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Provider Practice Location Address
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Address Line | 1721 GRIFFIN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90031-3312
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Country | US
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Telephone | 323-221-4134
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Fax |
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Provider Business Mailing Address
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Address Line | 5716 MICHIGAN AVE STE 4100
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City | DETROIT
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State | MI
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Zip | 48210-3039
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Country | US
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Telephone | 313-963-2266
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 112113
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 112113
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License Number State | CA
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