Sandra Rae Hansbrough

Individual provider Active NPI Dental Hygienist · Forest Ranch, CA

NPI 1124886635 · NPPES record last updated Mar 8, 2024

Key facts

NPI
1124886635
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
20395 (CA)
Practice address
15110 Siwini Rd # 132
Forest Ranch, CA 95942-9664
Phone
(530) 521-9300
NPI assigned
Mar 8, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 20395 CA Yes

Addresses

Primary practice location

15110 Siwini Rd # 132
Forest Ranch, CA 95942-9664

Mailing address

15110 Siwini Rd # 132
Forest Ranch, CA 95942-9664
Phone (530) 521-9300

Other providers in Forest Ranch, CA

All providers in Forest Ranch, CA · Dental Hygienist in California

Sources for this page

Verify at the official NPI Registry.