Provider Demographics
NPI:1396002945
Name:HARRIS, SHEILA SHOGHIAN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:SHOGHIAN
Last Name:HARRIS
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 1:850 E OCEAN BLVD UNIT 205
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5446
Mailing Address - Country:US
Mailing Address - Phone:562-495-0316
Mailing Address - Fax:
Practice Address - Street 1:850 E OCEAN BLVD UNIT 205
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-5446
Practice Address - Country:US
Practice Address - Phone:562-495-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant