Provider Demographics
NPI:1578801577
Name:VELASQUEZ, SIERRA D (NP)
Entity Type:Individual
Prefix:MS
First Name:SIERRA
Middle Name:D
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4721 DALLAS RANCH ROAD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8811
Mailing Address - Country:US
Mailing Address - Phone:925-778-0679
Mailing Address - Fax:925-778-3567
Practice Address - Street 1:4721 DALLAS RANCH ROAD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8811
Practice Address - Country:US
Practice Address - Phone:925-778-0679
Practice Address - Fax:925-778-3567
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA22320363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health