Provider Demographics
NPI:1851313787
Name:BRESNAHAN, SANDRA H T (RN, BSN, MSN, ACNP)
Entity Type:Individual
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First Name:SANDRA
Middle Name:H T
Last Name:BRESNAHAN
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Gender:F
Credentials:RN, BSN, MSN, ACNP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:4620 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5538
Mailing Address - Country:US
Mailing Address - Phone:310-791-7378
Mailing Address - Fax:
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:BUILDING 500 - MAILCODE 111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-478-3711
Practice Address - Fax:310-268-4812
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA491439163W00000X
CA12091363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care