Provider Demographics
NPI:1326584343
Name:GAYTAN-SANCHEZ, JACQUELINE
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:GAYTAN-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 1:398 N FAIR OAKS AVE
Mailing Address - Street 2:APT 6
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3899
Mailing Address - Country:US
Mailing Address - Phone:650-656-3062
Mailing Address - Fax:
Practice Address - Street 1:398 N FAIR OAKS AVE
Practice Address - Street 2:APT 6
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-3899
Practice Address - Country:US
Practice Address - Phone:650-656-3062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst