Provider Demographics
NPI:1003584426
Name:SANDERS, ARTESIA DELORIS (RN)
Entity Type:Individual
Prefix:
First Name:ARTESIA
Middle Name:DELORIS
Last Name:SANDERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94603-3404
Mailing Address - Country:US
Mailing Address - Phone:925-705-2066
Mailing Address - Fax:
Practice Address - Street 1:2302 103RD AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94603-3404
Practice Address - Country:US
Practice Address - Phone:925-705-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95174590163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care