Provider Demographics
NPI:1356994909
Name:SANCHEZ, JOAQUIN M (CADC A051270719)
Entity type:Individual
Prefix:MR
First Name:JOAQUIN
Middle Name:M
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:CADC A051270719
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 W WHITES BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-1225
Mailing Address - Country:US
Mailing Address - Phone:559-264-5096
Mailing Address - Fax:559-223-2898
Practice Address - Street 1:2445 W WHITES BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-1225
Practice Address - Country:US
Practice Address - Phone:559-264-5096
Practice Address - Fax:559-223-2898
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA051270719101YA0400X, 101YA0400X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)