Provider Demographics
NPI:1851844153
Name:SANCHEZ MURO, WENDY KARINA
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:KARINA
Last Name:SANCHEZ MURO
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 1:15350 NORDHOFF ST
Mailing Address - Street 2:STE A
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-2234
Mailing Address - Country:US
Mailing Address - Phone:818-672-8228
Mailing Address - Fax:
Practice Address - Street 1:15350 NORDHOFF ST
Practice Address - Street 2:STE A
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-2234
Practice Address - Country:US
Practice Address - Phone:818-672-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80035126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA80035Medicaid