Provider Demographics
NPI:1447675178
Name:CROWDER, SABRINA (FNP)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:CROWDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 EAKER WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6539
Mailing Address - Country:US
Mailing Address - Phone:510-682-8409
Mailing Address - Fax:925-778-8828
Practice Address - Street 1:526 EAKER WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6539
Practice Address - Country:US
Practice Address - Phone:510-682-8409
Practice Address - Fax:925-778-8828
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA653795163W00000X
CA95000464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse