Provider Demographics
NPI:1386032175
Name:KERANEN, SHERYL CATHERINE (PTA)
Entity Type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:CATHERINE
Last Name:KERANEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 CALIFORNIA ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0233
Mailing Address - Country:US
Mailing Address - Phone:906-231-5664
Mailing Address - Fax:
Practice Address - Street 1:6400 PURDUE DR
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-7095
Practice Address - Country:US
Practice Address - Phone:707-443-5668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10457225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant