Healthcare Provider Details

I. General information

NPI: 1457695132
Provider Name (Legal Business Name): SHERRELL SIANOYA ABRIAM ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHERELL CASTILLO SIANOYA

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 TIMBERLAKE WAY STE 107
SACRAMENTO CA
95823-5413
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 916-681-6000
  • Fax: 916-681-6188
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number22624
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: