Provider Demographics
NPI:1164617700
Name:TORRES, SHARON A (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:A
Last Name:TORRES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7248 SOUTH LAND PARK DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3661
Mailing Address - Country:US
Mailing Address - Phone:916-392-4000
Mailing Address - Fax:916-392-7215
Practice Address - Street 1:2101 STONE BLVD.
Practice Address - Street 2:SUITE 190
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-4044
Practice Address - Country:US
Practice Address - Phone:916-371-4939
Practice Address - Fax:916-371-5401
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19268363A00000X
CAPA19268363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0078351OtherMEDICAL
CA1164617700Medicaid
CAZZZ13862ZMedicare PIN
CABX743YMedicare PIN