Healthcare Provider Details

I. General information

NPI: 1689338196
Provider Name (Legal Business Name): SARAH ELIZABETH GRAZIANI APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH CARPENTER

II. Dates (important events)

Enumeration Date: 10/30/2021
Last Update Date: 07/10/2024
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24411 HEALTH CENTER DR
LAGUNA HILLS CA
92653-3651
US

IV. Provider business mailing address

24411 HEALTH CENTER DR STE 200
LAGUNA HILLS CA
92653-3633
US

V. Phone/Fax

Practice location:
  • Phone: 949-829-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number799783
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95019009
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: