Individual
SARAH VAILLANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
200 COTTAGE AVE, MANTECA, CA 95336-4935
(209) 624-5800
(209) 762-6808
Mailing address
5609 ANTIQUE ROSE WAY, RIVERBANK, CA 95367-9594
(603) 913-4238
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201708786RN
OR
363LW0102X
Women's Health Nurse Practitioner
Primary
95010894
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
10/20/2017
Last updated
05/05/2023
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