Basic Information
| Provider Information | |||||||||
| NPI: | 1114051588 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERRARONE | ||||||||
| FirstName: | CARLO | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 455 OCONNOR DR | ||||||||
| Address2: | SUITE 390 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951281633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4089180405 | ||||||||
| FaxNumber: | 4089180409 | ||||||||
| Practice Location | |||||||||
| Address1: | 1110 N DUTTON AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA ROSA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954014606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7073965151 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 12/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA 17917 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.