MEDICARE: REGINA LE-GRAND-SAWYER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1952439465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA LE-GRAND-SAWYER

Provider Business Mailing Address
First Line	:	1096 THUNDER RANCH WAY
Second Line	:
City	:	PLUMAS LAKE
State	:	CA
Zip	:	95961-9188
Country	:	US
Telephone Number	:	916-730-7641
Fax Number	:

Provider Business Practice Location Address
First Line	:	1096 THUNDER RANCH WAY
Second Line	:
City	:	PLUMAS LAKE
State	:	CA
Zip	:	95961-9188
Country	:	US
Telephone Number	:	916-730-7641
Fax Number	:	916-875-7029

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	11/13/2023

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