Provider Demographics
NPI:1912556002
Name:SHARKEY, JOHN ALAN (MMS, PA-C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ALAN
Last Name:SHARKEY
Suffix:
Gender:M
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 EL CAMINO REAL
Mailing Address - Street 2:STE 100
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1090
Mailing Address - Country:US
Mailing Address - Phone:650-325-6000
Mailing Address - Fax:
Practice Address - Street 1:285 N EL CAMINO REAL STE 117
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5384
Practice Address - Country:US
Practice Address - Phone:760-633-1000
Practice Address - Fax:760-753-8657
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7664363AM0700X
CA59763363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical