Provider Demographics
NPI:1386071744
Name:SANCHEZ, ERNESTO
Entity type:Individual
Prefix:MR
First Name:ERNESTO
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 816 KM 5.8 BO NUEVO
Mailing Address - Street 2:RR 11 BOX 5829 PMB 56 BO NUEVO
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-477-0548
Mailing Address - Fax:
Practice Address - Street 1:CARR 816 KM 5.8 BO NUEVO
Practice Address - Street 2:RR 11 BOX 5829 PMB 56 BO NUEVO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-5829
Practice Address - Country:US
Practice Address - Phone:787-477-0548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5207103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist