1326185646 NPI number — DR. SHARON JOYCE SCLABASSI PHD LCSW

Table of content: DR. SHARON JOYCE SCLABASSI PHD LCSW (NPI 1326185646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326185646 NPI number — DR. SHARON JOYCE SCLABASSI PHD LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCLABASSI
Provider First Name:
SHARON
Provider Middle Name:
JOYCE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HENDERSON
Provider Other First Name:
SHARON
Provider Other Middle Name:
JOYCE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1326185646
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 HOSPITAL PKWY STE 370
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95119-1136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-972-3383
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 HOSPITAL PARKWAY
Provider Second Line Business Practice Location Address:
#370 KAISER PERMANENTE
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-972-3366
Provider Business Practice Location Address Fax Number:
408-972-3353
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY16020 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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