Provider Demographics
NPI:1386335115
Name:SANCHEZ, GRICELDA JANET
Entity type:Individual
Prefix:
First Name:GRICELDA
Middle Name:JANET
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81709 DR CARREON BLVD STE B1
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5510
Mailing Address - Country:US
Mailing Address - Phone:760-347-0000
Mailing Address - Fax:
Practice Address - Street 1:81709 DR CARREON BLVD STE B1
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5510
Practice Address - Country:US
Practice Address - Phone:760-347-0000
Practice Address - Fax:760-347-0020
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty