Healthcare Provider Details

I. General information

NPI: 1417353277
Provider Name (Legal Business Name): MEREDITH CHIN SANDERS MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 STEVENS AVE SUITE 100
SOLANA BEACH CA
92075-2063
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-9800
  • Fax:
Mailing address:
  • Phone: 858-554-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number851476
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001628
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: