Provider Demographics
NPI:1497488019
Name:SANCHEZ, GARY HARO (MS, PPS, LEP)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:HARO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MS, PPS, LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12623 AVENUE 416
Mailing Address - Street 2:
Mailing Address - City:OROSI
Mailing Address - State:CA
Mailing Address - Zip Code:93647-2017
Mailing Address - Country:US
Mailing Address - Phone:559-528-4763
Mailing Address - Fax:559-528-3132
Practice Address - Street 1:12623 AVENUE 416
Practice Address - Street 2:
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647-2017
Practice Address - Country:US
Practice Address - Phone:559-528-4763
Practice Address - Fax:559-528-3132
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALEP2985103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool