Provider Demographics
NPI:1174962054
Name:BROOME, SARAH ELIZABETH (PA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:BROOME
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4165 BLACKHAWK PLAZA CIR 100
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-4691
Mailing Address - Country:US
Mailing Address - Phone:925-736-7070
Mailing Address - Fax:925-736-7075
Practice Address - Street 1:2021 MAIN ST
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-3302
Practice Address - Country:US
Practice Address - Phone:925-776-8200
Practice Address - Fax:925-776-8260
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA22781363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant