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General NPI Number Information
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NPI Number | 1023135902
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Entity Type | Individual
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Provider Name | SHERRIE ANN SHIOTA PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3885
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Fax | 510-597-7169
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Provider Business Mailing Address
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Address Line | 1874 CANNON DR
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2233
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Country | US
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Telephone | 925-287-1944
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 15278
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 15278
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA15278
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License Number State | CA
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