Provider Demographics
NPI:1477796688
Name:BACA-ASHER, JOSEFINA SANCHEZ (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JOSEFINA
Middle Name:SANCHEZ
Last Name:BACA-ASHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:450 BROADWAY ST FL A1
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-3132
Mailing Address - Country:US
Mailing Address - Phone:650-250-2584
Mailing Address - Fax:650-498-5947
Practice Address - Street 1:450 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063
Practice Address - Country:US
Practice Address - Phone:650-250-2584
Practice Address - Fax:650-721-3420
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA53721363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA53721OtherPHYSICIAN ASSISTANT LICENSE