Provider Demographics
NPI:1033891924
Name:SANDONE, RONALD J
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:SANDONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6486 N BAIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-8819
Mailing Address - Country:US
Mailing Address - Phone:559-260-7957
Mailing Address - Fax:559-319-8117
Practice Address - Street 1:4361 W FREMONT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-9783
Practice Address - Country:US
Practice Address - Phone:559-389-0315
Practice Address - Fax:559-319-8117
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107209222310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility