Provider Demographics
NPI:1023675071
Name:MITCHELL, SHAROLUNDA BRENA
Entity type:Individual
Prefix:
First Name:SHAROLUNDA
Middle Name:BRENA
Last Name:MITCHELL
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 1:4605 BUENA VISTA RD STE 600-502
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8791
Mailing Address - Country:US
Mailing Address - Phone:562-310-3871
Mailing Address - Fax:
Practice Address - Street 1:4067 HARDWICK ST # 206
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2350
Practice Address - Country:US
Practice Address - Phone:562-310-3871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-24
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty