Provider Demographics
NPI:1770197881
Name:SAWYER, JUANCARLOS GARLAND (FNP)
Entity Type:Individual
Prefix:
First Name:JUANCARLOS
Middle Name:GARLAND
Last Name:SAWYER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 BECKY LN
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6966
Mailing Address - Country:US
Mailing Address - Phone:530-403-8590
Mailing Address - Fax:
Practice Address - Street 1:5319 BECKY LN
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6966
Practice Address - Country:US
Practice Address - Phone:530-403-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily