Healthcare Provider Details

I. General information

NPI: 1790099216
Provider Name (Legal Business Name): FLORA W STONDELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 X STREET
SACRAMENTO CA
95817-2229
US

IV. Provider business mailing address

4501 X STREET SUITE 3016
SACRAMENTO CA
95817-2229
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5959
  • Fax: 916-734-0631
Mailing address:
  • Phone: 916-734-5959
  • Fax: 916-734-7946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberNP19818
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP19818
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: