Provider Demographics
NPI:1609941947
Name:SANCHEZ, JUAN ALBERTO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:ALBERTO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1782
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95109-1782
Mailing Address - Country:US
Mailing Address - Phone:408-398-0026
Mailing Address - Fax:
Practice Address - Street 1:2090 EVANS LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-2072
Practice Address - Country:US
Practice Address - Phone:408-793-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12558104100000X
CA251981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker