Provider Demographics
NPI:1144423591
Name:SEPULVEDA, SONIA ARGANDAR
Entity Type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:ARGANDAR
Last Name:SEPULVEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 PICADILLY WAY
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-7005
Mailing Address - Country:US
Mailing Address - Phone:209-824-1725
Mailing Address - Fax:
Practice Address - Street 1:1301 RICHLAND AVE APT 345
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351-5023
Practice Address - Country:US
Practice Address - Phone:209-538-9984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA183012164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse