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General NPI Number Information
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NPI Number | 1548350093
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Entity Type | Individual
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Provider Name | SARAH. TERANISHI FNP
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 SHIELD AVE
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City | DAVIS
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State | CA
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Zip | 95616-5270
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Country | US
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Telephone | 530-752-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 1480 INGRID DRIVE
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City | DIXON
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State | CA
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Zip | 95620-4222
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Country | US
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Telephone | 707-678-0604
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | T171680
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License Number State | CA
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