Provider Demographics
NPI:1548800618
Name:SARSAK, FATEMAH (PA-C)
Entity Type:Individual
Prefix:
First Name:FATEMAH
Middle Name:
Last Name:SARSAK
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 1:26024 ACERO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2768
Mailing Address - Country:US
Mailing Address - Phone:714-545-5550
Mailing Address - Fax:949-609-0374
Practice Address - Street 1:1310 W STEWART DR STE 306
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3838
Practice Address - Country:US
Practice Address - Phone:714-545-5550
Practice Address - Fax:949-609-0374
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2023-10-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician