Healthcare Provider Details

I. General information

NPI: 1881878395
Provider Name (Legal Business Name): SHARMILA SHERRY SEWELL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARMILA S. SINGH

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
STANFORD CA
94305-2200
US

IV. Provider business mailing address

300 PASTEUR DR
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-4000
  • Fax: 206-568-7043
Mailing address:
  • Phone: 650-723-4000
  • Fax: 206-568-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA10005356
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA10005356
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number56512
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: