Healthcare Provider Details

I. General information

NPI: 1114102340
Provider Name (Legal Business Name): SHERRIE ZAVATTERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 FOWLER LN STE 102
DIAMOND SPRINGS CA
95619-9782
US

IV. Provider business mailing address

PO BOX 1987
DIAMOND SPRINGS CA
95619-1987
US

V. Phone/Fax

Practice location:
  • Phone: 530-626-3105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: