Provider Demographics
NPI:1073166831
Name:KOCSIS, SANDRA LUCILLE
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LUCILLE
Last Name:KOCSIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-0447
Mailing Address - Country:US
Mailing Address - Phone:916-622-3609
Mailing Address - Fax:916-780-1679
Practice Address - Street 1:108 BEN EZRA AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2702
Practice Address - Country:US
Practice Address - Phone:916-960-3905
Practice Address - Fax:916-780-1679
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based