Healthcare Provider Details

I. General information

NPI: 1841714136
Provider Name (Legal Business Name): SARAH BETH RASMUSSEN WHNP, NM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 07/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 W HIGHWAY 246
BUELLTON CA
93427-9459
US

IV. Provider business mailing address

PO BOX 779
SUMMERLAND CA
93067-0779
US

V. Phone/Fax

Practice location:
  • Phone: 805-686-8555
  • Fax: 805-686-8556
Mailing address:
  • Phone: 310-699-2762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number235877
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95007053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: