Provider Demographics
NPI:1225223134
Name:SANCHEZ, YESENIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:YESENIA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24910 WASHINGTON AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9284
Mailing Address - Country:US
Mailing Address - Phone:714-794-5433
Mailing Address - Fax:951-595-4912
Practice Address - Street 1:24910 WASHINGTON AVE STE 202
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9284
Practice Address - Country:US
Practice Address - Phone:714-794-5433
Practice Address - Fax:951-595-4912
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA350951041C0700X
171M00000X, 390200000X
CA714681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1225223134Medicaid