Provider Demographics
NPI:1417001918
Name:SANCHEZ, UBALDO F (PHD)
Entity Type:Individual
Prefix:DR
First Name:UBALDO
Middle Name:F
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3104
Mailing Address - Country:US
Mailing Address - Phone:650-570-7391
Mailing Address - Fax:
Practice Address - Street 1:727 INDUSTRIAL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3391
Practice Address - Country:US
Practice Address - Phone:650-571-5986
Practice Address - Fax:650-458-8250
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11076103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY110760Medicaid
CAOPL110760Medicare ID - Type Unspecified