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General NPI Number Information
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NPI Number | 1760959282
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Entity Type | Individual
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Provider Name | SARA LANGSTON
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Gender | Female
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 1401 KEENEY WAY
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City | SACRAMENTO
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State | CA
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Zip | 95864-2632
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Country | US
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Telephone | 916-912-9674
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15316
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City | SACRAMENTO
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State | CA
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Zip | 95851-0316
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Country | US
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Telephone | 916-912-9674
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | D6229700
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License Number State | CA
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