Healthcare Provider Details

I. General information

NPI: 1326461344
Provider Name (Legal Business Name): NICOLE SHERFIELD PA, MMS, DMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N FULTON ST
FRESNO CA
93728-3404
US

IV. Provider business mailing address

1691 THE ALAMEDA
SAN JOSE CA
95126-2203
US

V. Phone/Fax

Practice location:
  • Phone: 559-488-4900
  • Fax: 559-488-4999
Mailing address:
  • Phone:
  • Fax: 408-287-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number51387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: