Provider Demographics
NPI:1174147839
Name:FORBES SANCHEZ, RAQUEL PATRICIA
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:PATRICIA
Last Name:FORBES 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 1:44 CLOVERLEAF CIR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-1437
Mailing Address - Country:US
Mailing Address - Phone:295-207-9078
Mailing Address - Fax:
Practice Address - Street 1:5019 FERNBANK WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8563
Practice Address - Country:US
Practice Address - Phone:925-207-9078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider