Provider Demographics
NPI:1821851130
Name:SANCHEZ, MARY JEAN (DNP, RN, ED, PHN)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:JEAN
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:DNP, RN, ED, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 GREEN RIVER RD STE 105 #1102
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882
Mailing Address - Country:US
Mailing Address - Phone:909-721-9545
Mailing Address - Fax:
Practice Address - Street 1:2485 SIERRA BELLA DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882
Practice Address - Country:US
Practice Address - Phone:909-721-9545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA653111163W00000X, 163WG0000X, 163WH0200X, 163WA2000X, 163WC1600X, 163WS0121X, 163WX0601X, 163WH1000X, 163WI0600X, 163WP2201X, 163WX0800X, 163WX1100X
CA75240163WC1500X, 251K00000X, 364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
No163WX0601XNursing Service ProvidersRegistered NurseOtorhinolaryngology & Head-Neck
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
No163WX1100XNursing Service ProvidersRegistered NurseOphthalmic
No251K00000XAgenciesPublic Health or Welfare