Provider Demographics
NPI:1871638031
Name:SHERRILL, ANGEL DIANDRA YVETTE
Entity Type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:DIANDRA YVETTE
Last Name:SHERRILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 62ND ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2701
Mailing Address - Country:US
Mailing Address - Phone:510-741-2831
Mailing Address - Fax:
Practice Address - Street 1:2465 DOLAN WAY
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-1668
Practice Address - Country:US
Practice Address - Phone:510-741-2831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2470A2800XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationAssistant Record Technician