Healthcare Provider Details

I. General information

NPI: 1881396877
Provider Name (Legal Business Name): STEPHANIE SANDERS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 QUALITY DR
VACAVILLE CA
95688-9494
US

IV. Provider business mailing address

907 3RD ST # 188
DAVIS CA
95616-4202
US

V. Phone/Fax

Practice location:
  • Phone: 707-624-2600
  • Fax:
Mailing address:
  • Phone: 805-746-0472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A24844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: