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NPI 1720323850

NPI 1720323850 : MISS SHEILA MARLENE SANDERS : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1720323850
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    Entity Type          |    Individual 
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    Provider Name        |    MISS SHEILA MARLENE SANDERS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/29/2012
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    Last Update Date     |    12/17/2012
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Provider Practice Location Address
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    Address Line         |    3875 S WESTERN AVE 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90062-1105
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    Country              |    US
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    Telephone            |    626-254-9853
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    13315 FLORWOOD AVE 
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    City                 |    HAWTHORNE
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    State                |    CA
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    Zip                  |    90250-6149
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    Country              |    US
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    Telephone            |    310-560-5789
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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        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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