Provider Demographics
NPI:1972672038
Name:RICHARDS, SANDRA MAY (PHN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MAY
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PHN
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:MAY
Other - Last Name:COFFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHN
Mailing Address - Street 1:885 SHELLWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3843
Mailing Address - Country:US
Mailing Address - Phone:916-422-4417
Mailing Address - Fax:
Practice Address - Street 1:7001A EAST PKWY # 500
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2501
Practice Address - Country:US
Practice Address - Phone:916-875-5701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA162017163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health