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NPI Code Detail

MEDICARE: MR. RUDOLPH SANCHEZ COUNSELOR

MEDICARE: MR. RUDOLPH SANCHEZ COUNSELOR
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2103K00000XBehavior Analyst1-20-41321CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
119-13OTHERCAOTHER

General Provider Information

NPI Number : 1780827220
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RUDOLPH SANCHEZ COUNSELOR
Provider Business Mailing Address
First Line : 942 S ATLANTIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-4004
Country : US
Telephone Number : 323-263-9700
Fax Number : 323-263-8042
Provider Business Practice Location Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2009
Last Update Date : 02/22/2021

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