Provider Demographics
NPI:1477832996
Name:STRATTON, SARA ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:STRATTON
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 1:19270 SONOMA HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-5414
Mailing Address - Country:US
Mailing Address - Phone:707-939-6070
Mailing Address - Fax:707-939-6077
Practice Address - Street 1:19270 SONOMA HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-5414
Practice Address - Country:US
Practice Address - Phone:707-939-6070
Practice Address - Fax:707-939-6070
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21718363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA17650OtherMEDICAL LICENSE