Provider Demographics
NPI:1669831442
Name:SANCHEZ, ALICIA I
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:SANCHEZ
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3738 S GOLD RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-3029
Mailing Address - Country:US
Mailing Address - Phone:310-972-9122
Mailing Address - Fax:
Practice Address - Street 1:3738 S GOLD RIDGE DR
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-3029
Practice Address - Country:US
Practice Address - Phone:310-972-9122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT213814882171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter