Provider Demographics
NPI:1477189512
Name:FOSHEE, SANDRA J
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:FOSHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48918 MOJAVE DR
Mailing Address - Street 2:
Mailing Address - City:MORONGO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92256-9243
Mailing Address - Country:US
Mailing Address - Phone:707-217-3160
Mailing Address - Fax:
Practice Address - Street 1:48918 MOJAVE DR
Practice Address - Street 2:
Practice Address - City:MORONGO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92256-9243
Practice Address - Country:US
Practice Address - Phone:707-217-3160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician