Provider Demographics
NPI:1184705451
Name:HAASE, SANDRA KAY (CS)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KAY
Last Name:HAASE
Suffix:
Gender:F
Credentials:CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5180 VIA CARRETAS
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4554
Mailing Address - Country:US
Mailing Address - Phone:714-779-7391
Mailing Address - Fax:714-693-2472
Practice Address - Street 1:5180 VIA CARRETAS
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-4554
Practice Address - Country:US
Practice Address - Phone:714-779-7391
Practice Address - Fax:714-693-2472
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist