Provider Demographics
NPI:1700370145
Name:GOMEZ SANCHES, ALEXANDRA ESTHER
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ESTHER
Last Name:GOMEZ SANCHES
Suffix:
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 1:10 DAFFODIL LN
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-1552
Mailing Address - Country:US
Mailing Address - Phone:408-904-9722
Mailing Address - Fax:
Practice Address - Street 1:1001 SNEATH LN STE 200
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-2349
Practice Address - Country:US
Practice Address - Phone:650-243-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst