Provider Demographics
NPI:1518164854
Name:IGNAT, SHARON PENTONY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:PENTONY
Last Name:IGNAT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CALLE CANELA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-7001
Mailing Address - Country:US
Mailing Address - Phone:949-306-7570
Mailing Address - Fax:949-429-6125
Practice Address - Street 1:2200 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2501
Practice Address - Country:US
Practice Address - Phone:949-548-2273
Practice Address - Fax:949-548-4504
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily