Provider Demographics
NPI:1740398163
Name:CAREY, SHAREN (PA-C)
Entity Type:Individual
Prefix:
First Name:SHAREN
Middle Name:
Last Name:CAREY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45950 CLEAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BIG SUR
Mailing Address - State:CA
Mailing Address - Zip Code:93920-9532
Mailing Address - Country:US
Mailing Address - Phone:831-667-2993
Mailing Address - Fax:
Practice Address - Street 1:46896 HIGHWAY ONE
Practice Address - Street 2:
Practice Address - City:BIGSUR
Practice Address - State:CA
Practice Address - Zip Code:93920
Practice Address - Country:US
Practice Address - Phone:831-667-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11252363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMM70332FMedicaid
CACMM70332FMedicaid
S89404Medicare UPIN