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General NPI Number Information
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NPI Number | 1205982071
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Entity Type | Individual
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Provider Name | SANDRA LYNN JAY NP
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 1450 MEDICAL CENTER DRIVE SUITE 3
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City | ROHNERT PARK
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State | CA
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Zip | 94928
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Country | US
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Telephone | 707-547-4684
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Fax | 707-585-7925
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Provider Business Mailing Address
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Address Line | 1154 MONTGOMERY DR STE 6
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City | SANTA ROSA
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State | CA
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Zip | 95405-4816
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Country | US
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Telephone | 707-547-4684
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Fax | 707-585-7925
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 316638
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License Number State | CA
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