Provider Demographics
NPI:1225778269
Name:GRABER, SHARI BETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:BETH
Last Name:GRABER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5929 INDIAN TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-5766
Mailing Address - Country:US
Mailing Address - Phone:818-601-4212
Mailing Address - Fax:
Practice Address - Street 1:5929 INDIAN TERRACE DR
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-5766
Practice Address - Country:US
Practice Address - Phone:818-601-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA630188164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse