Provider Demographics
NPI:1356884472
Name:PRITCHARD, SANDRA (RN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:MICHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:13272 OPAL WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-7790
Mailing Address - Country:US
Mailing Address - Phone:530-276-9676
Mailing Address - Fax:
Practice Address - Street 1:720 WOOD ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4413
Practice Address - Country:US
Practice Address - Phone:707-268-2990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA369613283Q00000X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No283Q00000XHospitalsPsychiatric Hospital