Provider Demographics
NPI:1710068002
Name:SANCHEZ, RAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 STADIUM DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-5166
Mailing Address - Country:US
Mailing Address - Phone:712-271-6463
Mailing Address - Fax:712-271-6464
Practice Address - Street 1:3930 STADIUM DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-5166
Practice Address - Country:US
Practice Address - Phone:712-271-6463
Practice Address - Fax:712-271-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist