Provider Demographics
NPI:1871972331
Name:SANCHEZ, JOHANNA MONIQUE
Entity type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:MONIQUE
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 1:2515 PALM PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-6620
Mailing Address - Country:US
Mailing Address - Phone:323-485-2619
Mailing Address - Fax:
Practice Address - Street 1:6736 LAUREL CANYON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1538
Practice Address - Country:US
Practice Address - Phone:818-755-8786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator