Provider Demographics
NPI:1306969464
Name:SANCHEZ, DARLENE LYNDA (NP)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:LYNDA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4104
Mailing Address - Country:US
Mailing Address - Phone:323-726-1727
Mailing Address - Fax:
Practice Address - Street 1:405 N MACLAY AVE STE 104
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-2455
Practice Address - Country:US
Practice Address - Phone:818-361-3318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP16811363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology