Healthcare Provider Details

I. General information

NPI: 1154861987
Provider Name (Legal Business Name): SANDRA FORTE CNA, HHA, RNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 01/19/2025
Certification Date: 01/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21151 S WESTERN AVE
TORRANCE CA
90501-1724
US

IV. Provider business mailing address

21151 S WESTERN AVE
TORRANCE CA
90501-1724
US

V. Phone/Fax

Practice location:
  • Phone: 562-310-9215
  • Fax: 888-792-6665
Mailing address:
  • Phone: 562-310-9215
  • Fax: 888-792-6665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number583752
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number00280800
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License NumberG1907747
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number00965715
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: