Provider Demographics
NPI:1124537972
Name:SANDERS, JANICE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:KINGSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:93631-2216
Mailing Address - Country:US
Mailing Address - Phone:559-817-9295
Mailing Address - Fax:
Practice Address - Street 1:1393 BAILEY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5922
Practice Address - Country:US
Practice Address - Phone:559-582-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553716163W00000X
CA15939363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse