Healthcare Provider Details
I. General information
NPI: 1538341557
Provider Name (Legal Business Name): CLAUDIA ANDREA FERRADA-MASIA P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/30/2007
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 DELBON AVE
TURLOCK CA
95382-2016
US
IV. Provider business mailing address
180 VIA VERDE STE 100
SAN DIMAS CA
91773-3993
US
V. Phone/Fax
- Phone: 209-667-4200
- Fax: 626-447-6057
- Phone: 626-447-0296
- Fax: 626-447-6057
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA19371 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: