Healthcare Provider Details

I. General information

NPI: 1053430181
Provider Name (Legal Business Name): SANDRA JENNEAN PREASMYER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 12/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S MAIN ST
ORANGE CA
92868-3835
US

IV. Provider business mailing address

1 SANTA NELLA
RANCHO SANTA MARGARITA CA
92688-2686
US

V. Phone/Fax

Practice location:
  • Phone: 714-532-8634
  • Fax:
Mailing address:
  • Phone: 949-589-2283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number565001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: