Provider Demographics
NPI:1992476030
Name:PRECI, SANDRA CHRISTINE (RN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:CHRISTINE
Last Name:PRECI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22485 CANAL CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5084
Mailing Address - Country:US
Mailing Address - Phone:909-827-3190
Mailing Address - Fax:
Practice Address - Street 1:22485 CANAL CIR
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5084
Practice Address - Country:US
Practice Address - Phone:909-827-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40287163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse