Provider Demographics
NPI:1104205483
Name:SHERMEIL K DASS M D A PROFESSIONAL
Entity Type:Organization
Organization Name:SHERMEIL K DASS M D A PROFESSIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERMEIL
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:DASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-421-2723
Mailing Address - Street 1:655 CAPITOLA ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CO
Mailing Address - Zip Code:95062-2747
Mailing Address - Country:US
Mailing Address - Phone:831-421-2723
Mailing Address - Fax:831-477-9908
Practice Address - Street 1:655 CAPITOLA RD STE 200
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2769
Practice Address - Country:US
Practice Address - Phone:831-421-2723
Practice Address - Fax:831-477-9908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty