Provider Demographics
NPI:1689016438
Name:SANCHEZ, MELODY (FNP)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25170 HANCOCK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5969
Mailing Address - Country:US
Mailing Address - Phone:514-619-3009
Mailing Address - Fax:951-461-9399
Practice Address - Street 1:25170 HANCOCK AVE STE 200
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5969
Practice Address - Country:US
Practice Address - Phone:951-461-9300
Practice Address - Fax:951-461-9399
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2022-06-17
Deactivation Date:2014-01-10
Deactivation Code:
Reactivation Date:2017-10-05
Provider Licenses
StateLicense IDTaxonomies
CA797971163W00000X
CA95007662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse