Provider Demographics
NPI:1528157807
Name:SANCHEZ, SENDI MARIA (PA)
Entity type:Individual
Prefix:
First Name:SENDI
Middle Name:MARIA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 OLIVAS PARK DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7672
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:852 W VENTURA ST
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1837
Practice Address - Country:US
Practice Address - Phone:805-524-2672
Practice Address - Fax:805-524-3953
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15388363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM18553HMedicaid
CARHM08608FMedicaid
CAZZT40394FMedicaid
CARHM08609FMedicaid
CAWPA15388DMedicare ID - Type UnspecifiedPPIN
CAZZT40394FMedicaid
CAWPA15388CMedicare ID - Type UnspecifiedPPIN
CAWPA15388AMedicare ID - Type UnspecifiedPPIN
CARHM18553HMedicaid
CARHM08609FMedicaid
CARHM08608FMedicaid
CAWPA15388EMedicare ID - Type UnspecifiedPPIN