Provider Demographics
NPI:1356764542
Name:CISNEROS, SASHA-ANN L
Entity type:Individual
Prefix:MS
First Name:SASHA-ANN
Middle Name:L
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SASHA-ANN
Other - Middle Name:L
Other - Last Name:PINNOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:888 BRANDY OAKS LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-2025
Mailing Address - Country:US
Mailing Address - Phone:678-598-0147
Mailing Address - Fax:
Practice Address - Street 1:888 BRANDY OAKS LN
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-2025
Practice Address - Country:US
Practice Address - Phone:678-598-0147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide