Provider Demographics
NPI:1013340751
Name:OASIS HEALTH AND WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:OASIS HEALTH AND WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:IMADE
Authorized Official - Last Name:ODIASE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP, FNP-BC
Authorized Official - Phone:916-479-1332
Mailing Address - Street 1:7275 E SOUTHGATE DR STE 408
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2632
Mailing Address - Country:US
Mailing Address - Phone:916-706-0416
Mailing Address - Fax:
Practice Address - Street 1:7275 E. SOUTHGATE DR SUIT 408
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2629
Practice Address - Country:US
Practice Address - Phone:916-479-1332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-16
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17711363LP2300X, 363LW0102X, 364SP0810X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & FamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty