Provider Demographics
NPI:1023204781
Name:IGNACIO, SHERYLLENE (MD)
Entity Type:Individual
Prefix:
First Name:SHERYLLENE
Middle Name:
Last Name:IGNACIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21263 ERWIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3715
Mailing Address - Country:US
Mailing Address - Phone:818-592-3100
Mailing Address - Fax:818-592-3015
Practice Address - Street 1:21263 ERWIN ST
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-3715
Practice Address - Country:US
Practice Address - Phone:818-592-3100
Practice Address - Fax:818-592-3015
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1102592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry