Provider Demographics
NPI:1588693204
Name:DASS, SHERMEIL K (MD)
Entity type:Individual
Prefix:
First Name:SHERMEIL
Middle Name:K
Last Name:DASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 CAPITOLA RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2769
Mailing Address - Country:US
Mailing Address - Phone:831-421-2723
Mailing Address - Fax:831-477-9908
Practice Address - Street 1:655 CAPITOLA RD STE 200
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2769
Practice Address - Country:US
Practice Address - Phone:831-421-2723
Practice Address - Fax:831-477-9908
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA782142084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA78214OtherMEDICAL LICENSE #
CAZZZ92069ZOtherMEDICARE GROUP ID#
CA00A782140Medicaid
CA00A782140Medicare PIN
CABD6342240OtherDEA #
CAH63189Medicare UPIN
CAA78214OtherMEDICAL LICENSE #
CAZZZ91892ZOtherMEDICARE GROUP ID#
CAZZZ92073ZOtherMEDICARE GROUP ID#