Provider Demographics
NPI:1356818967
Name:SANDERS, SAARA NIAMAT (PA-C)
Entity Type:Individual
Prefix:
First Name:SAARA
Middle Name:NIAMAT
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SAARA
Other - Middle Name:ASHLEY
Other - Last Name:NIAMAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:29645 RANCHO CALIFORNIA RD # 117
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591
Mailing Address - Country:US
Mailing Address - Phone:951-506-0187
Mailing Address - Fax:951-506-0189
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD # 117
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591
Practice Address - Country:US
Practice Address - Phone:951-506-0187
Practice Address - Fax:951-506-0189
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA55991363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant