Provider Demographics
NPI:1386877579
Name:CORRIGAN, SANDRA LYNNE (FNP-BC, CNN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LYNNE
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:FNP-BC, CNN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2160
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93020-2160
Mailing Address - Country:US
Mailing Address - Phone:818-718-2301
Mailing Address - Fax:818-718-2311
Practice Address - Street 1:375 ROLLING OAKS DR STE 100
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1024
Practice Address - Country:US
Practice Address - Phone:805-497-7775
Practice Address - Fax:805-557-1074
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP19226163WD1100X
CA19226363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal