Provider Demographics
NPI:1902610777
Name:SANFORD, ALLYSON CHRISTINE (LVN)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:CHRISTINE
Last Name:SANFORD
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:CHRISTINE
Other - Last Name:RONQUILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:1765 E SANDALWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-7372
Mailing Address - Country:US
Mailing Address - Phone:559-308-0092
Mailing Address - Fax:
Practice Address - Street 1:1646 S COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4962
Practice Address - Country:US
Practice Address - Phone:559-308-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA685139164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse