Provider Demographics
NPI:1013407519
Name:ANTIDO, SHERYL RONABIO (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:RONABIO
Last Name:ANTIDO
Suffix:
Gender:F
Credentials:MSN, FNP-C
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:12437 PATRICIA DR
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7140
Mailing Address - Country:US
Mailing Address - Phone:562-310-6703
Mailing Address - Fax:
Practice Address - Street 1:12507 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-7351
Practice Address - Country:US
Practice Address - Phone:562-802-2203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily