Provider Demographics
NPI:1467946731
Name:SANCHEZ, RALPH ANGEL (RALPH)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:ANGEL
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:RALPH
Other - Prefix:
Other - First Name:RALPH
Other - Middle Name:ANGEL
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13001 RAMONA BLVD STE I
Mailing Address - Street 2:
Mailing Address - City:IRWINDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3752
Mailing Address - Country:US
Mailing Address - Phone:626-337-3828
Mailing Address - Fax:
Practice Address - Street 1:13001 RAMONA BLVD STE 1
Practice Address - Street 2:
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706
Practice Address - Country:US
Practice Address - Phone:626-254-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator