Provider Demographics
NPI:1053059584
Name:CISNEROS SANCHEZ, ANA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:CISNEROS 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 1:1110 S OXNARD BLVD APT 205
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-9274
Mailing Address - Country:US
Mailing Address - Phone:805-865-4073
Mailing Address - Fax:
Practice Address - Street 1:1110 S OXNARD BLVD APT 205
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-9274
Practice Address - Country:US
Practice Address - Phone:805-865-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician