MEDICARE: MISS MARIA DE LOURDEZ SANCHEZ

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	104100000X	Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ICAN774	OTHER	CA	LA COUNTY DMH

General Provider Information

NPI Number	:	1245425578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARIA DE LOURDEZ SANCHEZ

Provider Business Mailing Address
First Line	:	4503 BRESEE AVE
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-2413
Country	:	US
Telephone Number	:	626-833-5072
Fax Number	:

Provider Business Practice Location Address
First Line	:	11001 VALLEY MALL
Second Line	:	SUITE 300
City	:	EL MONTE
State	:	CA
Zip	:	91731-2620
Country	:	US
Telephone Number	:	626-442-0710
Fax Number	:	626-442-8381

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

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	09/10/2007

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Directions to “ MISS MARIA DE LOURDEZ SANCHEZ ” Practice Location

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