Provider Demographics
NPI:1932568896
Name:SANCHEZ, JENNIFER CRYSTAL
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CRYSTAL
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 1:200 PINE AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-3039
Mailing Address - Country:US
Mailing Address - Phone:714-904-4097
Mailing Address - Fax:
Practice Address - Street 1:9265 SKY PARK CT STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4375
Practice Address - Country:US
Practice Address - Phone:844-737-3638
Practice Address - Fax:619-403-9496
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW85175104100000X
CALCSW1229581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker