| Doctor Name: | SANDRA LYNN JAY |
| NPI Number: | 1205982071 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 316638 |
| Business Practice Address: | 1450 Medical Center Drive Suite 3 Rohnert Park, CA - 94928 |
| Business Phone Number: | 7075474684 |
| Business Fax Number: | 7075857925 |
| Mailing Address: | 1154 Montgomery Dr, Ste 6 SANTA ROSA |
| State: | CA |
| Postal Code: | 954054816 |
| Phone Number: | 7075474684 |
| Fax Number: | 7075857925 |
| NPI Enumeration Date: | 01/26/2007 |
| NPI Last Update Date: | 03/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 316638 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |