Provider Demographics
NPI:1366294076
Name:ZARKA, SHIREEN ZIAD
Entity type:Individual
Prefix:
First Name:SHIREEN
Middle Name:ZIAD
Last Name:ZARKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41003 DIANA LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-1535
Mailing Address - Country:US
Mailing Address - Phone:909-855-4104
Mailing Address - Fax:
Practice Address - Street 1:1600 E FLORIDA AVE STE 315
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-8639
Practice Address - Country:US
Practice Address - Phone:951-765-1766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily