Healthcare Provider Details

I. General information

NPI: 1003903469
Provider Name (Legal Business Name): SANDRA JO RICE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WARNER AVE & COLLEGE DR CHICO STATE UNIVERSITY, STUDENT HEALTH SERVICE
CHICO CA
95929-0777
US

IV. Provider business mailing address

620 PARKWOOD DR
CHICO CA
95928-9159
US

V. Phone/Fax

Practice location:
  • Phone: 530-898-5241
  • Fax: 530-898-4057
Mailing address:
  • Phone: 530-898-4566
  • Fax: 530-898-6687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP5787
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: