Healthcare Provider Details

I. General information

NPI: 1518656990
Provider Name (Legal Business Name): ROCHELLE ANN SANDELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SANTA LOUISA
IRVINE CA
92606-8880
US

IV. Provider business mailing address

201 SANTA LOUISA
IRVINE CA
92606-8880
US

V. Phone/Fax

Practice location:
  • Phone: 949-387-7140
  • Fax:
Mailing address:
  • Phone: 949-387-7140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number642157
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: