Provider Demographics
NPI:1366991804
Name:SANGCO, KAREN
Entity type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:
Last Name:SANGCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 DELNA MANOR LN APT 1
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3414
Mailing Address - Country:US
Mailing Address - Phone:408-799-4006
Mailing Address - Fax:
Practice Address - Street 1:1105 DELNA MANOR LN APT 1
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3414
Practice Address - Country:US
Practice Address - Phone:408-799-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA807116163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse