Basic Information
| Provider Information | |||||||||
| NPI: | 1568936037 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANCHEZ | ||||||||
| FirstName: | KANDACE | ||||||||
| MiddleName: | K | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14223 N HILLS VILLAGE DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782492564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108501157 | ||||||||
| FaxNumber: | 2108501157 | ||||||||
| Practice Location | |||||||||
| Address1: | 7272 WURZBACH RD STE 203 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782404802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108632124 | ||||||||
| FaxNumber: | 2102611821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2019 | ||||||||
| LastUpdateDate: | 02/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 14571 | TX | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | 81798 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.