Provider Demographics
NPI:1154861987
Name:FORTE, SANDRA (CNA, HHA, RNA)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:FORTE
Suffix:
Gender:F
Credentials:CNA, HHA, RNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21151 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1724
Mailing Address - Country:US
Mailing Address - Phone:562-310-9215
Mailing Address - Fax:888-792-6665
Practice Address - Street 1:21151 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1724
Practice Address - Country:US
Practice Address - Phone:562-310-9215
Practice Address - Fax:888-792-6665
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583752101YP1600X
CA00280800374U00000X
CAG1907747405300000X
CA00965715376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No374U00000XNursing Service Related ProvidersHome Health Aide
No405300000XOther Service ProvidersPrevention Professional