Provider Demographics
NPI:1164003109
Name:CHUA, SHERILYN MARIE MISENAS (NP)
Entity Type:Individual
Prefix:
First Name:SHERILYN MARIE
Middle Name:MISENAS
Last Name:CHUA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8850 VALLEY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-3562
Mailing Address - Country:US
Mailing Address - Phone:714-827-7321
Mailing Address - Fax:760-510-1811
Practice Address - Street 1:8850 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-3562
Practice Address - Country:US
Practice Address - Phone:714-827-7321
Practice Address - Fax:760-510-1811
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330197353Medicaid