Provider Demographics
NPI:1902987415
Name:CHEEMA, BROOKE (PA-C)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:CHEEMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EL COLEGIO BLDG 588
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-0001
Mailing Address - Country:US
Mailing Address - Phone:805-893-4794
Mailing Address - Fax:805-893-3861
Practice Address - Street 1:EL COLEGIO BLDG 588
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-0001
Practice Address - Country:US
Practice Address - Phone:805-893-4794
Practice Address - Fax:805-893-3861
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13587363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical