Provider Demographics
NPI:1992559967
Name:SANCHEZ, ALICIA ANNETTE
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANNETTE
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 1:12440 FIRESTONE BLVD STE 1027
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-4366
Mailing Address - Country:US
Mailing Address - Phone:562-256-5193
Mailing Address - Fax:
Practice Address - Street 1:12440 FIRESTONE BLVD STE 1027
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4366
Practice Address - Country:US
Practice Address - Phone:562-256-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9853174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist