Provider Demographics
NPI:1851782437
Name:SANS, NYLE
Entity Type:Individual
Prefix:
First Name:NYLE
Middle Name:
Last Name:SANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NYLE
Other - Middle Name:
Other - Last Name:JAGANATH-SANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6028
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95604-6028
Mailing Address - Country:US
Mailing Address - Phone:530-878-5166
Mailing Address - Fax:916-797-8979
Practice Address - Street 1:730 SUNRISE AVE STE 200
Practice Address - Street 2:SUITES 201, 250, 260, 261, 271
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4549
Practice Address - Country:US
Practice Address - Phone:916-782-3737
Practice Address - Fax:916-782-3739
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)