Individual provider Active NPI

Stephen Sanchez

  • Case Manager/Care Coordinator
  • Azusa, CA
National Provider Identifier
1104236124
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
190081AN Issued in CA
Practice address
23701 E East Fork Rd
Azusa, CA 91702-1477
Phone
(626) 250-3290
NPI assigned
Apr 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 190081AN CA Primary

Addresses

Primary practice location

23701 E East Fork Rd
Azusa, CA 91702-1477

Mailing address

23701 E East Fork Rd
Azusa, CA 91702-1477
Phone (626) 250-3290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
190081ANCAMDCase Manager/Care Coordinator

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1104236124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23701 E EAST FORK RD",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917021477",
            "telephone_number": "626-250-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23701 E EAST FORK RD",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917021477",
            "telephone_number": "626-250-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "STEPHEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "190081AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Azusa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.