Provider Demographics
NPI:1699246371
Name:SANCHEZ, HEATHER (FNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18047 BEACH BLVD STE 1038
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1304
Mailing Address - Country:US
Mailing Address - Phone:562-231-6631
Mailing Address - Fax:
Practice Address - Street 1:6032 THOR DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2419
Practice Address - Country:US
Practice Address - Phone:562-231-6631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily