MALLORY SANDRIDGE NP NPI 1861854572

NPI Information

NPI: 1861854572
Provider Name: MALLORY SANDRIDGE, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
5 HARRIS COURT, BUILDING T
SUITE 201
MONTEREY, CA
ZIP 93940
Phone: (831) 375-4105
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Mallory Sandridge, NP is a family nurse practitioner in Monterey, CA with 9 years of experience. Mallory Sandridge, NP NPI is 1861854572. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5 HARRIS COURT, BUILDING T
SUITE 201
MONTEREY, CA
ZIP 93940-750
Phone: (831) 375-4105
Fax: (831) 372-5722

The NPI 1861854572 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/22/2016 and was last updated on 2/6/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		0024173408	VIRGINIA	No
2	363L00000X	Nurse Practitioner		95010564	CALIFORNIA	No
3	363LF0000X	Nurse Practitioner	Family	0024173408	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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