Individual
MARIA-DOLORES CERQUEIRA HANEFFANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3100 DOUGLAS BLVD, ROSEVILLE, CA 95661-3866
(916) 774-8300
(916) 773-7145
Mailing address
10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA13226
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA13226
PHYSICIAN ASSIST LIC
CA
Enumeration date
09/14/2006
Last updated
07/24/2015
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