Provider Demographics
NPI:1225123177
Name:LACHICA, SHEILA MAE (PA-C)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MAE
Last Name:LACHICA
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 1:168 W CARSON ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2601
Mailing Address - Country:US
Mailing Address - Phone:310-233-3202
Mailing Address - Fax:310-233-3208
Practice Address - Street 1:168 W CARSON ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2601
Practice Address - Country:US
Practice Address - Phone:310-233-3202
Practice Address - Fax:310-233-3208
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16002363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA16002Medicaid