Provider Demographics
NPI:1508952383
Name:VICKERS SANCHEZ, AIMEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:
Last Name:VICKERS SANCHEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:VICKERS RIFFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 27920
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-7920
Mailing Address - Country:US
Mailing Address - Phone:559-708-8708
Mailing Address - Fax:559-449-3066
Practice Address - Street 1:8050 N PALM AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711
Practice Address - Country:US
Practice Address - Phone:559-708-8708
Practice Address - Fax:559-449-3066
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20191103T00000X, 103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ46938Medicare UPIN