Provider Demographics
NPI:1841868270
Name:SAHAGUN, SYLVIA
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:SAHAGUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25638 MESA EDGE CT
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92585-8969
Mailing Address - Country:US
Mailing Address - Phone:562-569-5324
Mailing Address - Fax:
Practice Address - Street 1:601 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4335
Practice Address - Country:US
Practice Address - Phone:951-391-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-13
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA708675164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse