Provider Demographics
NPI:1811302334
Name:DEAN, SARA (NP-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:508 E GIBSON BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5796
Mailing Address - Country:US
Mailing Address - Phone:916-773-5577
Mailing Address - Fax:
Practice Address - Street 1:508 E GIBSON BLVD
Practice Address - Street 2:STE 220
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5796
Practice Address - Country:US
Practice Address - Phone:916-773-5577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily