Provider Demographics
NPI:1568760254
Name:ADVANCED PRACTICE ASSOCIATES, PNC
Entity Type:Organization
Organization Name:ADVANCED PRACTICE ASSOCIATES, PNC
Other - Org Name:SIERRA FAMILY PRACTICE & URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PERRENOD
Authorized Official - Suffix:
Authorized Official - Credentials:NP, MSN
Authorized Official - Phone:530-559-5458
Mailing Address - Street 1:330 CAPE HORN RD E
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9434
Mailing Address - Country:US
Mailing Address - Phone:530-559-5458
Mailing Address - Fax:
Practice Address - Street 1:330 CAPE HORN RD E
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:CA
Practice Address - Zip Code:95713-9434
Practice Address - Country:US
Practice Address - Phone:530-559-5458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care