Healthcare Provider Details

I. General information

NPI: 1881967040
Provider Name (Legal Business Name): SARAH LYNN CAMPBELL N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E YALE LOOP STE 204
IRVINE CA
92604-4697
US

IV. Provider business mailing address

PO BOX 2163
NEWPORT BEACH CA
92659-1163
US

V. Phone/Fax

Practice location:
  • Phone: 949-732-3530
  • Fax: 949-732-3533
Mailing address:
  • Phone: 657-241-3600
  • Fax: 657-241-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: