Provider Demographics
NPI:1760408959
Name:BREED, CHERYL D (NP)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:D
Last Name:BREED
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:4501 X ST
Mailing Address - Street 2:SUITE 3016
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2229
Mailing Address - Country:US
Mailing Address - Phone:916-734-3771
Mailing Address - Fax:916-734-7946
Practice Address - Street 1:4501 X ST
Practice Address - Street 2:SUITE 3016
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2229
Practice Address - Country:US
Practice Address - Phone:916-734-3771
Practice Address - Fax:916-734-7946
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2011-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA6717363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0067170Medicaid
CAS75165Medicare UPIN
CA0067170Medicaid