Provider Demographics
NPI:1518002963
Name:SHERBATOVA, ISABELLA (PA)
Entity type:Individual
Prefix:MRS
First Name:ISABELLA
Middle Name:
Last Name:SHERBATOVA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 W JUNIPERO ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3943
Mailing Address - Country:US
Mailing Address - Phone:805-636-6005
Mailing Address - Fax:
Practice Address - Street 1:334 S PATTERSON AVE
Practice Address - Street 2:#120
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93111
Practice Address - Country:US
Practice Address - Phone:805-682-8844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18707363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA18707OtherSTATE LICENSE
CAPA18707OtherSTATE LICENSE