Provider Demographics
NPI:1194261321
Name:SANCHEZ, MARUSKA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MARUSKA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 W LUCILLE AVE
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95391-8302
Mailing Address - Country:US
Mailing Address - Phone:925-963-3387
Mailing Address - Fax:
Practice Address - Street 1:5348 TREEFLOWER DR
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-6905
Practice Address - Country:US
Practice Address - Phone:925-963-3387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-11
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004117363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner