Provider Demographics
NPI:1942229521
Name:QUIAMCO, SHERYL S (NP)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:S
Last Name:QUIAMCO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:T
Other - Last Name:SARMIENTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:8554 LURLINE AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-1223
Mailing Address - Country:US
Mailing Address - Phone:818-341-7099
Mailing Address - Fax:
Practice Address - Street 1:18546 ROSCOE BLVD
Practice Address - Street 2:STE 210
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4663
Practice Address - Country:US
Practice Address - Phone:818-886-5628
Practice Address - Fax:818-701-8042
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP15869164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP15869Medicare PIN