Provider Demographics
NPI:1326698473
Name:MEYER, SYLVIA J (PA-C)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:J
Last Name:MEYER
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 1:3273 CLAREMONT WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3328
Mailing Address - Country:US
Mailing Address - Phone:707-603-1060
Mailing Address - Fax:707-265-6435
Practice Address - Street 1:3273 CLAREMONT WAY STE 100
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3328
Practice Address - Country:US
Practice Address - Phone:707-603-1060
Practice Address - Fax:707-265-6435
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57196363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0102820Medicaid