Provider Demographics
NPI:1255465316
Name:SANCHEZ, ERICA ODETTE
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ODETTE
Last Name: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 1:2182 SEQUOIA AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2704
Mailing Address - Country:US
Mailing Address - Phone:805-577-1852
Mailing Address - Fax:
Practice Address - Street 1:11565 LAUREL CANYON BLVD
Practice Address - Street 2:#100
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4168
Practice Address - Country:US
Practice Address - Phone:818-365-4723
Practice Address - Fax:818-365-3475
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner