Provider Demographics
NPI:1043457237
Name:SANCHEZ, DEANNA LYN (FNP)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:LYN
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 1:203 S MICHILLINDA AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-4933
Mailing Address - Country:US
Mailing Address - Phone:626-405-8033
Mailing Address - Fax:
Practice Address - Street 1:203 S MICHILLINDA AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4933
Practice Address - Country:US
Practice Address - Phone:626-405-8033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily