Provider Demographics
NPI:1548816168
Name:HAMILTON, SARA (RN, BSN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23018 TIMBER RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-7783
Mailing Address - Country:US
Mailing Address - Phone:714-747-1406
Mailing Address - Fax:
Practice Address - Street 1:23018 TIMBER RIDGE CT
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7783
Practice Address - Country:US
Practice Address - Phone:714-747-1406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-11
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031139163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health