Provider Demographics
NPI:1518702513
Name:SANCHEZ, CHRISTIAN REY
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:REY
Last Name: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 1:13036 SAN CARLOS CT
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-6602
Mailing Address - Country:US
Mailing Address - Phone:760-488-3670
Mailing Address - Fax:
Practice Address - Street 1:13036 SAN CARLOS CT
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-6602
Practice Address - Country:US
Practice Address - Phone:760-488-3670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician