Provider Demographics
NPI:1538409669
Name:KREIZENBECK, SANDRA ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ANN
Last Name:KREIZENBECK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:ANN
Other - Last Name:KREIZENBECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:4463 STONERIDGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8402
Mailing Address - Country:US
Mailing Address - Phone:925-846-6300
Mailing Address - Fax:925-846-6323
Practice Address - Street 1:4463 STONERIDGE DR STE A
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8402
Practice Address - Country:US
Practice Address - Phone:925-846-6300
Practice Address - Fax:925-846-6323
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily