Provider Demographics
NPI:1083080964
Name:SANCHEZ, ULISES
Entity Type:Individual
Prefix:
First Name:ULISES
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9627 HICKORY ST
Mailing Address - Street 2:NONE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-2546
Mailing Address - Country:US
Mailing Address - Phone:323-592-4404
Mailing Address - Fax:
Practice Address - Street 1:9627 HICKORY ST
Practice Address - Street 2:NONE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-2546
Practice Address - Country:US
Practice Address - Phone:323-592-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst