Provider Demographics
NPI:1205067543
Name:DO, SHERRY (NP)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8692 WAGERS CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5027
Mailing Address - Country:US
Mailing Address - Phone:714-332-7016
Mailing Address - Fax:619-259-2582
Practice Address - Street 1:17822 BEACH BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7101
Practice Address - Country:US
Practice Address - Phone:714-332-7016
Practice Address - Fax:714-845-9941
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP19017363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner