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Individual

BRIGHT SAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7225 E SOUTHGATE DR STE D, SACRAMENTO, CA 95823-2651
(916) 912-4119
Mailing address
422 LIPIZZAN LN, CELINA, TX 75009-4657
(972) 357-5944

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
833764
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95025460
CA

Other

Enumeration date
10/05/2022
Last updated
10/14/2023
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