1942234265 NPI number — MS. SHARON LOUISE FERRIS MFCC

Table of content: MS. SHARON LOUISE FERRIS MFCC (NPI 1942234265)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942234265 NPI number — MS. SHARON LOUISE FERRIS MFCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRIS
Provider First Name:
SHARON
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MFCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FERRIS
Provider Other First Name:
SHERRI
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MFCC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1942234265
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:
1819 POLK ST
Provider Second Line Business Mailing Address:
SUITE 164
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94109-3003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-673-5311
Provider Business Mailing Address Fax Number:
415-673-5380

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1150 LOMBARD ST
Provider Second Line Business Practice Location Address:
#39
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94109-9102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-673-5311
Provider Business Practice Location Address Fax Number:
415-673-5380
Provider Enumeration Date:
07/11/2006

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: 106H00000X , with the licence number:  MP17797 , 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)

  • Identifier: MP17797 . This is a "MFC LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".