1669950291 NPI number — AIXA RUBI SANCHEZ BIS, SLP-A

Table of content: AIXA RUBI SANCHEZ BIS, SLP-A (NPI 1669950291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669950291 NPI number — AIXA RUBI SANCHEZ BIS, SLP-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANCHEZ
Provider First Name:
AIXA
Provider Middle Name:
RUBI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BIS, SLP-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669950291
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4461 S BOXWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YUMA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85365-6309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-257-2566
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 W 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUMA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85364-2973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-502-4300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/06/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2355S0801X , with the licence number:  SLPA11315 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)