Provider Demographics
NPI:1609897735
Name:SANCHEZ, AMY (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N BRAND BLVD UNIT 200
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3590
Mailing Address - Country:US
Mailing Address - Phone:323-229-2253
Mailing Address - Fax:
Practice Address - Street 1:201 N BRAND BLVD UNIT 200
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3590
Practice Address - Country:US
Practice Address - Phone:323-229-2253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT29681AMedicare ID - Type Unspecified