Provider Demographics
NPI:1932973401
Name:SEMPLE, SAHARA MARIE
Entity type:Individual
Prefix:
First Name:SAHARA
Middle Name:MARIE
Last Name:SEMPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 VAN BUREN DR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-4158
Mailing Address - Country:US
Mailing Address - Phone:951-539-7388
Mailing Address - Fax:
Practice Address - Street 1:12440 FIRESTONE BLVD STE 215
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4382
Practice Address - Country:US
Practice Address - Phone:951-539-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program