Provider Demographics
NPI:1972956233
Name:SANCHEZ, NANCY SICAIROS (LCSW, PPSC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:SICAIROS
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LCSW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-1010
Mailing Address - Country:US
Mailing Address - Phone:209-203-9836
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1010
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-1010
Practice Address - Country:US
Practice Address - Phone:209-203-9836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA96042101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program