Basic Information
| Provider Information | |||||||||
| NPI: | 1487955571 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAMENI | ||||||||
| FirstName: | SHERI | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26800 CROWN VALLEY PKWY STE 120 | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926918033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493643388 | ||||||||
| FaxNumber: | 9493645026 | ||||||||
| Practice Location | |||||||||
| Address1: | 26800 CROWN VALLEY PKWY STE 120 | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926918033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493643388 | ||||||||
| FaxNumber: | 9493645026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2010 | ||||||||
| LastUpdateDate: | 10/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 20380 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.