Provider Demographics
NPI:1982963658
Name:SHEROIAN, SHIRLEY ANN (NP)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:ANN
Last Name:SHEROIAN
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:PO BOX 7428
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92167-0428
Mailing Address - Country:US
Mailing Address - Phone:602-538-4821
Mailing Address - Fax:480-656-8766
Practice Address - Street 1:3873 W PARK AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-1390
Practice Address - Country:US
Practice Address - Phone:480-636-8712
Practice Address - Fax:480-466-7755
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP 4479363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health