Healthcare Provider Details

I. General information

NPI: 1750353231
Provider Name (Legal Business Name): LAURA SANFORD CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 08/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 OLD RIVER RD SUITE 200
BAKERSFIELD CA
93311-9503
US

IV. Provider business mailing address

300 OLD RIVER RD SUITE 200
BAKERSFIELD CA
93311-9503
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-4800
  • Fax: 661-663-4871
Mailing address:
  • Phone: 661-663-4800
  • Fax: 661-663-4871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number368191
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: