Provider Demographics
NPI:1710048723
Name:PRISAZNIK, SHERRI ANN (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:ANN
Last Name:PRISAZNIK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E YOSEMITE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 E YOSEMITE AVE STE B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8220
Practice Address - Country:US
Practice Address - Phone:209-722-9272
Practice Address - Fax:209-724-9329
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1069231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0010690Medicaid
CAAU0010692Medicaid
CAZZZ15037ZMedicare ID - Type Unspecified
CAAW430ZMedicare PIN