Provider Demographics
NPI:1205502432
Name:SATHER, CARA NICOLE (NP)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:NICOLE
Last Name:SATHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45161 SAGE RD
Mailing Address - Street 2:
Mailing Address - City:AGUANGA
Mailing Address - State:CA
Mailing Address - Zip Code:92536-9759
Mailing Address - Country:US
Mailing Address - Phone:760-518-7779
Mailing Address - Fax:
Practice Address - Street 1:45161 SAGE RD
Practice Address - Street 2:
Practice Address - City:AGUANGA
Practice Address - State:CA
Practice Address - Zip Code:92536-9759
Practice Address - Country:US
Practice Address - Phone:760-518-7779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014970363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner