Provider Demographics
NPI:1972717601
Name:SANCHEZ, GERALDINE P (OTR)
Entity Type:Individual
Prefix:MISS
First Name:GERALDINE
Middle Name:P
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:GERALDINE
Other - Middle Name:P
Other - Last Name:DE JESUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13578 HATCHER PL
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-2945
Mailing Address - Country:US
Mailing Address - Phone:909-463-7022
Mailing Address - Fax:
Practice Address - Street 1:13578 HATCHER PL
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-2945
Practice Address - Country:US
Practice Address - Phone:909-463-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4769225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist