Provider Demographics
NPI:1376757336
Name:SHERIDAN, CHRISTINA TEEN-WAI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:TEEN-WAI
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 S BASCOM AVE
Mailing Address - Street 2:SANTA CLARA VALLEY MEDICAL CENTER
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2604
Mailing Address - Country:US
Mailing Address - Phone:408-236-0687
Mailing Address - Fax:408-885-5418
Practice Address - Street 1:750 S BASCOM AVE, DEPARTMENT OF PEDIATRICS
Practice Address - Street 2:SANTA CLARA VALLEY MEDICAL CENTER
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2603
Practice Address - Country:US
Practice Address - Phone:408-236-0687
Practice Address - Fax:408-885-5418
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA851972080P0202X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics