Provider Demographics
NPI:1619634383
Name:SANCHEZ, SUSAN DENISE (PMHNP, DNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:DENISE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PMHNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 OAK ST STE 205
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2542
Mailing Address - Country:US
Mailing Address - Phone:541-787-2997
Mailing Address - Fax:
Practice Address - Street 1:312 OAK ST STE 205
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2542
Practice Address - Country:US
Practice Address - Phone:541-787-2997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202113272NP2084P0800X
OR202113272NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry