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NPI Code Detail

MEDICARE: LORRYANN SANDERS

MEDICARE: LORRYANN SANDERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2390200000XStudent in an Organized Health Care Education/Training Program
3171M00000XCase Manager/Care Coordinator
4225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1336722990
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORRYANN SANDERS
Provider Business Mailing Address
First Line : 499 LOMA ALTA AVE
Second Line :
City : LOS GATOS
State : CA
Zip : 95030-6227
Country : US
Telephone Number : 408-364-4157
Fax Number :
Provider Business Practice Location Address
First Line : 499 LOMA ALTA AVE
Second Line :
City : LOS GATOS
State : CA
Zip : 95030-6227
Country : US
Telephone Number : 408-364-4157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2021
Last Update Date : 06/02/2026

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