Healthcare Provider Details

I. General information

NPI: 1063913762
Provider Name (Legal Business Name): SANDRA BUCIC ZARICH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 02/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 JOHN MUIR PKWY
BRENTWOOD CA
94513-5183
US

IV. Provider business mailing address

289 FRANKLIN AVE
BAY POINT CA
94565-3317
US

V. Phone/Fax

Practice location:
  • Phone: 925-513-2483
  • Fax:
Mailing address:
  • Phone: 415-987-2762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95008386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: