Provider Demographics
NPI:1588235139
Name:SANCHEZ, JESSICA M (NP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:310-248-8245
Mailing Address - Fax:310-248-8249
Practice Address - Street 1:8631 W 3RD ST STE 635E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5994
Practice Address - Country:US
Practice Address - Phone:310-248-8245
Practice Address - Fax:310-248-8249
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95137659163WP2201X
CANP9501889363L00000X
CA95018889363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner