Basic Information
Provider Information
NPI: 1578892006
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANCHEZ
FirstName: YESICA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: B.A
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 2116 ARLINGTON AVE STE 200
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900181353
CountryCode: US
TelephoneNumber: 3237373900
FaxNumber: 3237373993
Practice Location
Address1: 2116 ARLINGTON AVE STE 200
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900181353
CountryCode: US
TelephoneNumber: 3237373900
FaxNumber: 3237373993
Other Information
ProviderEnumerationDate: 12/11/2009
LastUpdateDate: 12/11/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225400000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner 

No ID Information.


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