Provider Demographics
NPI:1962079145
Name:SANCHEZ, JESSICA ASHA (MS, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ASHA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6235 BEECH TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3170
Mailing Address - Country:US
Mailing Address - Phone:210-276-1700
Mailing Address - Fax:
Practice Address - Street 1:6235 BEECH TRAIL DR
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-3170
Practice Address - Country:US
Practice Address - Phone:210-276-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-21-50006103K00000X
HIBA-792103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst