Healthcare Provider Details

I. General information

NPI: 1861417917
Provider Name (Legal Business Name): COLLEEN LYN SAUNDERS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SANTA FE DR SUITE 204
ENCINITAS CA
92024-5138
US

IV. Provider business mailing address

320 SANTA FE DR SUITE 204
ENCINITAS CA
92024-5138
US

V. Phone/Fax

Practice location:
  • Phone: 760-944-7300
  • Fax: 760-633-3949
Mailing address:
  • Phone: 760-944-7300
  • Fax: 760-633-3949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number526954
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8755
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number8755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: