Provider Demographics
NPI:1689408767
Name:FALLENSTEIN, SHERRY LYNN I (MSCCC)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LYNN
Last Name:FALLENSTEIN
Suffix:I
Gender:F
Credentials:MSCCC
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Mailing Address - Street 1:PO BOX 4543
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91313-4543
Mailing Address - Country:US
Mailing Address - Phone:818-521-4474
Mailing Address - Fax:818-488-9612
Practice Address - Street 1:PO BOX 4543
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91313-4543
Practice Address - Country:US
Practice Address - Phone:818-521-4474
Practice Address - Fax:818-488-9612
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA27-0680139246Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology