Provider Demographics
NPI:1427260660
Name:SANCHEZ, CLARISSA ANDREA
Entity type:Individual
Prefix:
First Name:CLARISSA
Middle Name:ANDREA
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 1:6028 CARDINAL ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6510
Mailing Address - Country:US
Mailing Address - Phone:805-981-4200
Mailing Address - Fax:805-981-4201
Practice Address - Street 1:1911 WILLIAMS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-981-4200
Practice Address - Fax:805-981-4201
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator