Provider Demographics
NPI:1275037376
Name:TURNER, SANDRICKIA LAZELL (LVN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRICKIA
Middle Name:LAZELL
Last Name:TURNER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 EVERGREEN SQ
Mailing Address - Street 2:
Mailing Address - City:PORT HUENEME
Mailing Address - State:CA
Mailing Address - Zip Code:93041-2833
Mailing Address - Country:US
Mailing Address - Phone:805-330-7732
Mailing Address - Fax:
Practice Address - Street 1:454 EVERGREEN SQ
Practice Address - Street 2:
Practice Address - City:PORT HUENEME
Practice Address - State:CA
Practice Address - Zip Code:93041-2833
Practice Address - Country:US
Practice Address - Phone:805-330-7732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN215768164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse