Provider Demographics
NPI:1598443897
Name:DIGEORGE, SARAH HUMPHREY (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:HUMPHREY
Last Name:DIGEORGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2842 ROCKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-8623
Mailing Address - Country:US
Mailing Address - Phone:707-628-6691
Mailing Address - Fax:
Practice Address - Street 1:1860 PENNSYLVANIA AVE STE 120
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3550
Practice Address - Country:US
Practice Address - Phone:707-646-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023904363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care