Provider Demographics
NPI:1316492754
Name:SERATT, ALINA (PA-C)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:SERATT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33494 OAK GLEN RD
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-2057
Mailing Address - Country:US
Mailing Address - Phone:909-797-8900
Mailing Address - Fax:
Practice Address - Street 1:33494 OAK GLEN RD
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-2057
Practice Address - Country:US
Practice Address - Phone:909-797-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53963363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical