Provider Demographics
NPI:1912633074
Name:SARDINIA, JERAM NARBATO (LVN)
Entity Type:Individual
Prefix:
First Name:JERAM
Middle Name:NARBATO
Last Name:SARDINIA
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 HILL ST
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-3150
Mailing Address - Country:US
Mailing Address - Phone:415-336-1418
Mailing Address - Fax:
Practice Address - Street 1:74 HILL ST
Practice Address - Street 2:
Practice Address - City:BAY POINT
Practice Address - State:CA
Practice Address - Zip Code:94565-3150
Practice Address - Country:US
Practice Address - Phone:415-336-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA714889164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse