Sandra Sullivan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

23222 Issued in CA

Practice address

1207 E Herndon Ave
Fresno, CA 93720-3235

Phone

(559) 432-4303

Fax

(559) 432-4574

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cardiovascular Consultants of Fresno, a Professional Corporation

  dba Cardiovascular Consultants Heart Center

  • Interventional Cardiology Physician
  • Fresno, CA
  • NPI 1497724355
  NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1396172615
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1154541639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203235",
            "telephone_number": "559-432-4303",
            "fax_number": "559-432-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203235",
            "telephone_number": "559-432-4303",
            "fax_number": "559-432-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SANDRA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "641477",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sullivan Chiropractic Center Inc
• Bron David Sullivan
• Dominique Sullivan
• Joanna Leah Sullivan, PSY.D.
• Nancy Sullivan
• Savath Sullivan, R.N.
• Tongia Sullivan, AMFT
• Tyler Sullivan
• Nazeem Sultan, M.D.
• Preet Sumal, ACSW

• Family Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.