Provider Demographics
NPI:1457429086
Name:ACOB, CHERYL MIGUEL (NP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:MIGUEL
Last Name:ACOB
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1550 HARBOR BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-3826
Mailing Address - Country:US
Mailing Address - Phone:916-372-9893
Mailing Address - Fax:916-372-0630
Practice Address - Street 1:1550 HARBOR BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-3826
Practice Address - Country:US
Practice Address - Phone:916-372-9893
Practice Address - Fax:916-372-0630
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP7156363L00000X
CARN411062163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse