Individual
KELLY ANN SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAREGIVER
Contact information
Practice address
3861 PURPLE FINCH LN, MODESTO, CA 95355-8514
(209) 380-6119
Mailing address
3861 PURPLE FINCH LN, MODESTO, CA 95355-8514
(209) 380-6119
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
000204580
CA
Other
Enumeration date
08/07/2025
Last updated
08/07/2025
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