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General NPI Number Information
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NPI Number | 1164987335
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Entity Type | Individual
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Provider Name | MARY SPONSLER MSN, APRN, CNM, PHN
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Gender | Female
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 16575 DRAPER MINE RD
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City | SONORA
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State | CA
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Zip | 95370-8430
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Country | US
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Telephone | 209-533-2300
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Fax | 209-533-4300
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Provider Business Mailing Address
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Address Line | 19445 SOULSBYVILLE RD
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City | SOULSBYVILLE
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State | CA
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Zip | 95372-9742
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Country | US
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Telephone | 209-288-8726
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NMW236534
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN481611
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License Number State | CA
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