Provider Demographics
NPI:1285780437
Name:SAGERIAN, MARCELLE RITA (NP)
Entity type:Individual
Prefix:MS
First Name:MARCELLE
Middle Name:RITA
Last Name:SAGERIAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:25219 KERRI LN
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-4729
Mailing Address - Country:US
Mailing Address - Phone:858-353-0392
Mailing Address - Fax:760-440-9602
Practice Address - Street 1:3001 DOUGLAS BLVD
Practice Address - Street 2:SUITE #150
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3851
Practice Address - Country:US
Practice Address - Phone:858-353-0392
Practice Address - Fax:760-440-9602
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA13376363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology