Sherese M Akrotirianakis, PA

Individual provider Active NPI Physician Assistant · Fontana, CA

NPI 1871701474 · NPPES record last updated Apr 25, 2011

Key facts

NPI
1871701474
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
PA17276 (CA)
Practice address
9961 Sierra Ave
Dept of Family Medicine
Fontana, CA 92335-6720
Phone
(909) 427-5000
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17276CAMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17276 CA Yes

Addresses

Primary practice location

9961 Sierra Ave
Dept of Family Medicine
Fontana, CA 92335-6720

Mailing address

393 E. Walnut Street
PHR Group & Provider Enrollment Unit, 3Rd Floor
Pasadena, CA 91188-0001
Phone (626) 405-7966

Other names

  • Ms. Sherese M Scoto Di Vettimo Former name

Other providers in Fontana, CA

All providers in Fontana, CA · Physician Assistant in California

Sources for this page

Verify at the official NPI Registry.