Active NPI
Hannah P Sandy, NP
- Nurse Practitioner
- Yucaipa, CA
National Provider Identifier
1457420945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP 17642
- Practice address
- 11711 Sand Canyon Rd
Yucaipa, CA 92399-1742 - Phone
- (909) 389-3272
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 160601 | CO | |
| Nurse Practitioner | 363L00000X | NP 17642 | CA | Primary |
Addresses
Primary practice location
11711 Sand Canyon Rd
Yucaipa, CA 92399-1742
Mailing address
11711 Sand Canyon Rd
Yucaipa, CA 92399-1742
Phone (909) 389-3272
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17642 | CA | MD | Dentist |
| NP 17642 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437436800000",
"number": "1457420945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11711 SAND CANYON RD",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923991742",
"telephone_number": "909-389-3272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11711 SAND CANYON RD",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923991742",
"telephone_number": "909-389-3272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDY",
"first_name": "HANNAH",
"middle_name": "P",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2015-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "160601",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NP 17642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yucaipa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.