Provider Demographics
NPI:1730438979
Name:GREY, SARAH ANN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANN
Last Name:GREY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 COUNTRY CLUB DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-8371
Mailing Address - Country:US
Mailing Address - Phone:805-306-0222
Mailing Address - Fax:
Practice Address - Street 1:1070 COUNTRY CLUB DR
Practice Address - Street 2:SUITE C
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-8371
Practice Address - Country:US
Practice Address - Phone:805-306-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20876363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily