Healthcare Provider Details

I. General information

NPI: 1598490740
Provider Name (Legal Business Name): SARRAH ELIZABETH OAKESON AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 E GUASTI RD STE 315
ONTARIO CA
91761-1258
US

IV. Provider business mailing address

17855 DALLAS PKWY STE 200
DALLAS TX
75287-6857
US

V. Phone/Fax

Practice location:
  • Phone: 346-376-1702
  • Fax:
Mailing address:
  • Phone: 346-376-1702
  • Fax: 224-532-2780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95021105
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: