Provider Demographics
NPI:1205042611
Name:SCHARFFENBERG, SANDRA G (RN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:G
Last Name:SCHARFFENBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:ACAMPO
Mailing Address - State:CA
Mailing Address - Zip Code:95220-0520
Mailing Address - Country:US
Mailing Address - Phone:209-368-8281
Mailing Address - Fax:
Practice Address - Street 1:24250 N BUCK RD
Practice Address - Street 2:
Practice Address - City:ACAMPO
Practice Address - State:CA
Practice Address - Zip Code:95220-9613
Practice Address - Country:US
Practice Address - Phone:209-368-8281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA484027163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse