Provider Demographics
NPI:1629843248
Name:SANCHEZ, JOHNATHON LORENZO (DMFT)
Entity Type:Individual
Prefix:DR
First Name:JOHNATHON
Middle Name:LORENZO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S HARBOR BLVD STE 910
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-3721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 S HARBOR BLVD
Practice Address - Street 2:STE 910
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-3721
Practice Address - Country:US
Practice Address - Phone:323-746-0792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA121328106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist