Provider Demographics
NPI:1336220805
Name:SANCHEZ, ERICA JENSEN (MS)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:JENSEN
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:KEALY
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9560 SW NIMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7184
Mailing Address - Country:US
Mailing Address - Phone:971-319-0684
Mailing Address - Fax:
Practice Address - Street 1:15002 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4441
Practice Address - Country:US
Practice Address - Phone:602-867-5223
Practice Address - Fax:602-867-5252
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDOH #TSLP5091235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR015927OtherBOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY