Provider Demographics
NPI:1902560246
Name:SANCHEZ, JENNIFER NOEMI
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NOEMI
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-2822
Mailing Address - Country:US
Mailing Address - Phone:619-315-6219
Mailing Address - Fax:
Practice Address - Street 1:20695 S WESTERN AVE STE 132
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1834
Practice Address - Country:US
Practice Address - Phone:424-271-7414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker