Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | NPF95017623 | CA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | NPF95017623 | CA |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 26530 | TN |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | NPF95017623 | CA |
NPI | 1023659463 |
---|---|
Provider Name | Abigail Sanders |
First Address | San Diego, CA 92127-5705 |
Second Address | Carlsbad, CA 92008-7346 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2019 |
Last Update Date | 04/10/2021 |