Provider Demographics
NPI:1932967379
Name:JUAREZ SANCHEZ, JOSE ANGEL
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ANGEL
Last Name:JUAREZ SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6641 VALLEY HI DR APT 342
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-7037
Mailing Address - Country:US
Mailing Address - Phone:831-256-8145
Mailing Address - Fax:
Practice Address - Street 1:6641 VALLEY HI DR APT 342
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-7037
Practice Address - Country:US
Practice Address - Phone:831-256-8145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician