Provider Demographics
NPI:1427409192
Name:ROCHA, SHERI (PA-C)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:ROCHA
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 1:2670 S WHITE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2073
Mailing Address - Country:US
Mailing Address - Phone:408-729-4290
Mailing Address - Fax:
Practice Address - Street 1:3640 SAN MINETE CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-3714
Practice Address - Country:US
Practice Address - Phone:408-772-3581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53519363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant