Provider Demographics
NPI:1104171065
Name:SAYAT, CATHY TANG
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:TANG
Last Name:SAYAT
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 1:11660 CHURCH ST
Mailing Address - Street 2:UNIT 123
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8917
Mailing Address - Country:US
Mailing Address - Phone:909-524-6808
Mailing Address - Fax:
Practice Address - Street 1:11660 CHURCH ST
Practice Address - Street 2:UNIT 123
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8917
Practice Address - Country:US
Practice Address - Phone:909-524-6808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4272367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered