Provider Demographics
NPI:1821149220
Name:SANCHEZ, DIANA
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:SAUCIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1825 E THELBORN ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1442
Mailing Address - Country:US
Mailing Address - Phone:626-915-3844
Mailing Address - Fax:626-915-3845
Practice Address - Street 1:1825 E THELBORN ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1442
Practice Address - Country:US
Practice Address - Phone:626-915-3844
Practice Address - Fax:626-915-3845
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA051203101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)