Provider Demographics
NPI:1508639170
Name:CRUZ HERNANDEZ, SANDRA KAREN (PA)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:KAREN
Last Name:CRUZ HERNANDEZ
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:7707 COLLEGE TOWN DR APT 44
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2327
Mailing Address - Country:US
Mailing Address - Phone:916-612-1311
Mailing Address - Fax:
Practice Address - Street 1:7707 COLLEGE TOWN DR APT 44
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2327
Practice Address - Country:US
Practice Address - Phone:916-612-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant