Provider Demographics
NPI:1013230440
Name:GAFFER FERREIRA, MIRIAM MONA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:MONA
Last Name:GAFFER FERREIRA
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:28094 PETRINA CT
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4968
Mailing Address - Country:US
Mailing Address - Phone:510-783-5978
Mailing Address - Fax:510-783-5978
Practice Address - Street 1:2828 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1119
Practice Address - Country:US
Practice Address - Phone:510-848-8404
Practice Address - Fax:510-848-6312
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA20883363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical