Provider Demographics
NPI:1346933165
Name:SANDLER, NICOLE (NP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SANDLER
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 1:25422 TRABUCO RD # 105-154
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-2791
Mailing Address - Country:US
Mailing Address - Phone:949-264-2383
Mailing Address - Fax:
Practice Address - Street 1:2598 S ARCHIBALD AVE STE I
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-6500
Practice Address - Country:US
Practice Address - Phone:909-923-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA950245902083B0002X, 363LA2200X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist