Provider Demographics
NPI:1437478880
Name:SHERF, CAROLIN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:CAROLIN
Middle Name:
Last Name:SHERF
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7963 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-6070
Mailing Address - Country:US
Mailing Address - Phone:818-909-9955
Mailing Address - Fax:818-909-0454
Practice Address - Street 1:7963 VAN NUYS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-6070
Practice Address - Country:US
Practice Address - Phone:818-909-9955
Practice Address - Fax:818-909-0454
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20778363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA20778OtherPHYSICIAN ASSISTANT