Provider Demographics
NPI:1619290228
Name:HERRON, SHERYL HARGROVE (FNP)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:HARGROVE
Last Name:HERRON
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:PO BOX 8404
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-8404
Mailing Address - Country:US
Mailing Address - Phone:707-815-2234
Mailing Address - Fax:925-291-2679
Practice Address - Street 1:520 CAPITOL MALL STE 800
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-4716
Practice Address - Country:US
Practice Address - Phone:916-471-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA301863OtherBOARD OF REGISTERED NURSING