Provider Demographics
NPI:1962117978
Name:SEVERS, HANNAH SANDRA MAE (CBSPD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:SANDRA MAE
Last Name:SEVERS
Suffix:
Gender:F
Credentials:CBSPD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:SANDRA MAE
Other - Last Name:SEVERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CBSPD
Mailing Address - Street 1:39400 PASEO PADRE PKWY
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2310
Mailing Address - Country:US
Mailing Address - Phone:510-248-3000
Mailing Address - Fax:
Practice Address - Street 1:39400 PASEO PADRE PKWY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2310
Practice Address - Country:US
Practice Address - Phone:510-248-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49204246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist