Provider Demographics
NPI:1366635278
Name:SANCHEZ, JOHN GERARD (LISW, BCD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:GERARD
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:LISW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 DELEDDA RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-0609
Mailing Address - Country:US
Mailing Address - Phone:210-857-4200
Mailing Address - Fax:
Practice Address - Street 1:3520 DELEDDA RD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-0609
Practice Address - Country:US
Practice Address - Phone:210-857-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-06651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical