Provider Demographics
NPI:1831232354
Name:DEVOLL, SANDRA KAY (LVN)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KAY
Last Name:DEVOLL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 NEW DAWN CIR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-6811
Mailing Address - Country:US
Mailing Address - Phone:530-343-6208
Mailing Address - Fax:
Practice Address - Street 1:2179 BIDWELL AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-9609
Practice Address - Country:US
Practice Address - Phone:530-342-6413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN200999164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse