Provider Demographics
NPI:1114115565
Name:LANGE, SARAH ANNE (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:LANGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:LEEPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2589 SAMARITAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-3518
Mailing Address - Country:US
Mailing Address - Phone:650-683-5308
Mailing Address - Fax:
Practice Address - Street 1:1825 4TH ST FL 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2350
Practice Address - Country:US
Practice Address - Phone:415-885-3800
Practice Address - Fax:415-514-5661
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA552340363LF0000X
CA16963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily