Provider Demographics
NPI:1063063733
Name:SANCHEZ, ROCIO (OFFICE MANAGER)
Entity type:Individual
Prefix:
First Name:ROCIO
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:OFFICE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 MCNUTT RD STE D
Mailing Address - Street 2:
Mailing Address - City:SANTA TERESA
Mailing Address - State:NM
Mailing Address - Zip Code:88008-8001
Mailing Address - Country:US
Mailing Address - Phone:575-265-1717
Mailing Address - Fax:575-332-4453
Practice Address - Street 1:5805 MCNUTT RD STE D
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-8001
Practice Address - Country:US
Practice Address - Phone:575-265-1717
Practice Address - Fax:575-332-4453
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMPENDINGMedicaid