Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 95015507 | CA |
NPI | 1053918094 |
---|---|
Provider Name | Janel Nicole Sanglerat |
First Address | Santa Rosa, CA 95403-1032 |
Second Address | Santa Rosa, CA 95403-1032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2020 |
Last Update Date | 02/10/2020 |