Provider Demographics
NPI:1063619872
Name:SARGENT, DEBORAH ROY (NP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ROY
Last Name:SARGENT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24004 ARMINTA ST
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-6141
Mailing Address - Country:US
Mailing Address - Phone:818-704-8556
Mailing Address - Fax:
Practice Address - Street 1:7075 CAMPUS RD
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1605
Practice Address - Country:US
Practice Address - Phone:805-379-1413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA371820363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily