Provider Demographics
NPI:1073366985
Name:SANCHEZ, MARIAH M
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:M
Last Name:SANCHEZ
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2063 S SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-4833
Mailing Address - Country:US
Mailing Address - Phone:657-456-8558
Mailing Address - Fax:833-256-3911
Practice Address - Street 1:2063 S SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-4833
Practice Address - Country:US
Practice Address - Phone:657-456-8558
Practice Address - Fax:833-256-3911
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician