Provider Demographics
NPI:1164670592
Name:TURNER, VIVIAN SAKURA (PA)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:SAKURA
Last Name:TURNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3254 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-2412
Mailing Address - Country:US
Mailing Address - Phone:530-888-1016
Mailing Address - Fax:530-888-1346
Practice Address - Street 1:8007 E GOLDENROD LN
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-1937
Practice Address - Country:US
Practice Address - Phone:714-585-3985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15898363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant