Healthcare Provider Details

I. General information

NPI: 1679608301
Provider Name (Legal Business Name): SANDRA LYNN UHRIG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 W COAST HWY FL 4
NEWPORT BEACH CA
92663-4036
US

IV. Provider business mailing address

2549B EASTBLUFF DR # 227
NEWPORT BEACH CA
92660-3504
US

V. Phone/Fax

Practice location:
  • Phone: 949-629-0055
  • Fax:
Mailing address:
  • Phone: 909-816-4155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number14346
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number484403
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number14346
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: