Provider Demographics
NPI:1235228214
Name:PLUSH, SHERYL L (DC)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:L
Last Name:PLUSH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15520 ROCKFIELD BLVD A200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:18170 ARNOLD DR
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-4053
Practice Address - Country:US
Practice Address - Phone:707-939-3882
Practice Address - Fax:844-640-9917
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0278400OtherBLUE SHIELD
CAU97862Medicare UPIN
CADC0278400Medicare ID - Type Unspecified