MEDICARE: DR. OLIVIA SANCHEZ PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist

General Provider Information

NPI Number	:	1245357664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLIVIA SANCHEZ PSY.D.

Provider Business Mailing Address
First Line	:	11942 LOUISE AVE APT 8
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-5849
Country	:	US
Telephone Number	:	310-210-4714
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 LONG BEACH BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2011
Country	:	US
Telephone Number	:	310-783-4677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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