Provider Demographics
NPI:1275679979
Name:YOCUM, SANDRA GAIL (RN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:GAIL
Last Name:YOCUM
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 1:5074 NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-8373
Mailing Address - Country:US
Mailing Address - Phone:530-644-4157
Mailing Address - Fax:
Practice Address - Street 1:1126 MONTAGUE LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-3252
Practice Address - Country:US
Practice Address - Phone:916-543-9863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293018163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health