Provider Demographics
NPI:1730900812
Name:SANABRIA, DAVID (CHW/R)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SANABRIA
Suffix:
Gender:M
Credentials:CHW/R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 OASIS SPRINGS RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-2582
Mailing Address - Country:US
Mailing Address - Phone:505-659-3814
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 3338
Practice Address - Street 2:
Practice Address - City:TOHAJIILEE
Practice Address - State:NM
Practice Address - Zip Code:87026-3338
Practice Address - Country:US
Practice Address - Phone:505-908-2307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMG-1618172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker