Provider Demographics
NPI:1205937885
Name:PEARSON-NISHIOKA, DORIEL (PA-C)
Entity type:Individual
Prefix:MS
First Name:DORIEL
Middle Name:
Last Name:PEARSON-NISHIOKA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:SUMC - PEDS PHYSISCIAN BILLING MC: 5530
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-498-7391
Mailing Address - Fax:650-725-7888
Practice Address - Street 1:1855 BAY RD.
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303
Practice Address - Country:US
Practice Address - Phone:650-330-7400
Practice Address - Fax:650-321-1610
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA11886363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant