Provider Demographics
NPI:1245425891
Name:FRENCH, SANDRA RAQUEL (LVN)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:RAQUEL
Last Name:FRENCH
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:RAQUEL
Other - Last Name:ZAVALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:13349 AUGUSTA WAY
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-3961
Mailing Address - Country:US
Mailing Address - Phone:909-289-8919
Mailing Address - Fax:
Practice Address - Street 1:13349 AUGUSTA WAY
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-3961
Practice Address - Country:US
Practice Address - Phone:909-289-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA215771164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse