Healthcare Provider Details

I. General information

NPI: 1245900646
Provider Name (Legal Business Name): HERIBERTO SIERRA PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 STELLA DR
SINKING SPRING PA
19608-9069
US

IV. Provider business mailing address

55 STELLA DR
SINKING SPRING PA
19608-9069
US

V. Phone/Fax

Practice location:
  • Phone: 610-442-1065
  • Fax: 610-655-5267
Mailing address:
  • Phone: 610-442-1065
  • Fax: 610-655-5267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP95031129
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP221342
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5015150
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP031386
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: