Provider Demographics
NPI:1518729359
Name:LOPEZ DE SANCHEZ, ENGRACIA
Entity Type:Individual
Prefix:
First Name:ENGRACIA
Middle Name:
Last Name:LOPEZ DE SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 NORTHBEND ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-2130
Mailing Address - Country:US
Mailing Address - Phone:951-261-2225
Mailing Address - Fax:
Practice Address - Street 1:2350 NORTHBEND ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-2130
Practice Address - Country:US
Practice Address - Phone:951-261-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty