Provider Demographics
NPI:1588140230
Name:GRIESINGER, SHARON CHEPTUM (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:CHEPTUM
Last Name:GRIESINGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:27674 NEWHALL RANCH RD
Mailing Address - Street 2:STE C85
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4020
Mailing Address - Country:US
Mailing Address - Phone:661-383-7136
Mailing Address - Fax:818-356-4380
Practice Address - Street 1:276 HAWTHORNE ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-5908
Practice Address - Country:US
Practice Address - Phone:718-270-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA55541363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical