Provider Demographics
NPI:1639911589
Name:SAUNDERS, CHEYENNE ALEXIS (PA-C)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:ALEXIS
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHEYENNE
Other - Middle Name:ALEXIS
Other - Last Name:REES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:3016 ROMAN CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-4133
Mailing Address - Country:US
Mailing Address - Phone:916-761-6714
Mailing Address - Fax:
Practice Address - Street 1:13555 BOWMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3197
Practice Address - Country:US
Practice Address - Phone:530-885-3951
Practice Address - Fax:530-885-3932
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64625363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant