Healthcare Provider Details

I. General information

NPI: 1225538523
Provider Name (Legal Business Name): ALYSSA SANDQUIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST. JOHN'S REGIONAL MEDICAL CENTER - 1600 N ROSE AVENUE
OXNARD CA
93030-3722
US

IV. Provider business mailing address

62 W 7TH AVE STE 232
SPOKANE WA
99204-2321
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-2500
  • Fax: 805-485-3025
Mailing address:
  • Phone: 509-474-2041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61118837
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number232247
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNP95030240
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95030240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: