Sherian L Prince

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

100669 Issued in CA

Legal business name

SHERIAN L PRINCE

Doing business as

DBA PACIFIC MEDICAL SUPPLY

Practice address

620 Petaluma Blvd N Ste a
Petaluma, CA 94952-2870

Phone

(707) 769-9606

Fax

(707) 776-4659

NPI assigned

Nov 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sherian L Prince

Title

Owner

Phone

(707) 769-9606

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DBA PACIFIC MEDICAL SUPPLY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225100860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 PETALUMA BLVD N STE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522870",
            "telephone_number": "707-769-9606",
            "fax_number": "707-776-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PETALUMA BLVD N STE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522870",
            "telephone_number": "707-769-9606",
            "fax_number": "707-776-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIAN L PRINCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "SHERIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-769-9606",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "100669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME03174F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA PACIFIC MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalia Shapiro, MD
• Bert Wayne Sheckler-Smith, MFT
• Kristal Shelden, R.D.
• Adam D. Shemper, M.A.
• Michaela Shepphard, M.D.
• Sonya Shiffer, M.ED., BCBA
• Susie Shin-Calandrella, MD
• Dane Arthur Shoemaker, N.P.
• Samantha Shoemaker
• Richard A Shoninger

• Durable Medical Equipment & Medical Supplies in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.