Provider Demographics
NPI:1518622992
Name:SANCHEZ, MONICA SAMANTHA (LVN)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SAMANTHA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 ARROW HWY SPC 141
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-5628
Mailing Address - Country:US
Mailing Address - Phone:626-620-1122
Mailing Address - Fax:
Practice Address - Street 1:250 W ARTESIA ST
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-1807
Practice Address - Country:US
Practice Address - Phone:909-623-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA712372167G00000X, 164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No167G00000XNursing Service ProvidersLicensed Psychiatric Technician