Provider Demographics
NPI:1063204600
Name:SANCHEZ, JASMINE I (PPS)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:I
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12555 NAVAJO RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-7256
Mailing Address - Country:US
Mailing Address - Phone:760-247-8001
Mailing Address - Fax:
Practice Address - Street 1:11837 NAVAJO RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-7653
Practice Address - Country:US
Practice Address - Phone:760-247-7206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220155732101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool