Provider Demographics
NPI:1245362029
Name:FIEKOWSKY, SHARON DANA (NP)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:DANA
Last Name:FIEKOWSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 S SPRINGER RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-4832
Mailing Address - Country:US
Mailing Address - Phone:650-814-0257
Mailing Address - Fax:650-941-4821
Practice Address - Street 1:952 S SPRINGER RD
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-4832
Practice Address - Country:US
Practice Address - Phone:650-814-0257
Practice Address - Fax:650-941-4821
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17138363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health