Provider Demographics
NPI:1144328428
Name:DY, SARAH JANE AGANAN (ACNP)
Entity type:Individual
Prefix:MS
First Name:SARAH JANE
Middle Name:AGANAN
Last Name:DY
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5148 ROCKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1135
Mailing Address - Country:US
Mailing Address - Phone:323-255-5079
Mailing Address - Fax:
Practice Address - Street 1:14445 OLIVE VIEW DR
Practice Address - Street 2:2B-182 DEPARTMENT OF MEDICINE
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1437
Practice Address - Country:US
Practice Address - Phone:818-634-3205
Practice Address - Fax:818-362-4573
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA15997163WC0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine