Healthcare Provider Details

I. General information

NPI: 1093656159
Provider Name (Legal Business Name): NATALIE R SANDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3913 ZAKESSIAN CT
MODESTO CA
95356-0293
US

IV. Provider business mailing address

3913 ZAKESSIAN CT
MODESTO CA
95356-0293
US

V. Phone/Fax

Practice location:
  • Phone: 209-568-5313
  • Fax:
Mailing address:
  • Phone: 209-568-5313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN728825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: