Provider Demographics
NPI:1730649187
Name:APPEL, SAVANNAH JADE (NP)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:JADE
Last Name:APPEL
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 1:677 KAY AVE
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CA
Mailing Address - Zip Code:95570-9727
Mailing Address - Country:US
Mailing Address - Phone:707-845-6544
Mailing Address - Fax:
Practice Address - Street 1:1595 GRAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2450
Practice Address - Country:US
Practice Address - Phone:760-798-0428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011427363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics