=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811284284
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SANDRA R WEST
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2011
-----------------------------------------------------
Last Update Date | 06/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3820 GUNN HWY UNIT 100
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33618-8720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-571-4798
-----------------------------------------------------
Fax | 785-232-0160
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10752 ALICO PASS
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34655-4378
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-633-6687
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 172V00000X
-----------------------------------------------------
Taxonomy Name | Community Health Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 24759
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------