Provider Demographics
NPI:1942718069
Name:BANDY, SAUSHA (LVN)
Entity Type:Individual
Prefix:
First Name:SAUSHA
Middle Name:
Last Name:BANDY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12183 LOCKSLEY LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-2004
Mailing Address - Country:US
Mailing Address - Phone:530-878-5166
Mailing Address - Fax:
Practice Address - Street 1:12125 SHALE RIDGE LN
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-8880
Practice Address - Country:US
Practice Address - Phone:530-885-1917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA682695164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse