Provider Demographics
NPI:1003903469
Name:RICE, SANDRA JO (NP)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JO
Last Name:RICE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9159
Mailing Address - Country:US
Mailing Address - Phone:530-898-4566
Mailing Address - Fax:530-898-6687
Practice Address - Street 1:WARNER AVE & COLLEGE DR
Practice Address - Street 2:CHICO STATE UNIVERSITY, STUDENT HEALTH SERVICE
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95929-0777
Practice Address - Country:US
Practice Address - Phone:530-898-5241
Practice Address - Fax:530-898-4057
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP5787363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP5787OtherLICENSE