Provider Demographics
NPI:1629483417
Name:RECINOS, SHERYL LAURISSA (MD)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:LAURISSA
Last Name:RECINOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:LAURISSA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 802665
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-2665
Mailing Address - Country:US
Mailing Address - Phone:661-367-0040
Mailing Address - Fax:
Practice Address - Street 1:1600 W AVENUE J
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2894
Practice Address - Country:US
Practice Address - Phone:661-726-6260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA144280207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine