Provider Demographics
NPI:1083911135
Name:FLORES, SARAH OLIVIA (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:OLIVIA
Last Name:FLORES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:OLIVIA
Other - Last Name:PALOMINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:250 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-3813
Mailing Address - Country:US
Mailing Address - Phone:831-427-3500
Mailing Address - Fax:831-457-2486
Practice Address - Street 1:250 LOCUST ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3813
Practice Address - Country:US
Practice Address - Phone:831-427-3500
Practice Address - Fax:831-457-2486
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA742833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily