Healthcare Provider Details

I. General information

NPI: 1003711375
Provider Name (Legal Business Name): SHARMEELA MOQIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9440 W STOCKTON BLVD
ELK GROVE CA
95758-8001
US

IV. Provider business mailing address

9440 W STOCKTON BLVD
ELK GROVE CA
95758-8001
US

V. Phone/Fax

Practice location:
  • Phone: 916-513-2365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: