Healthcare Provider Details

I. General information

NPI: 1124837273
Provider Name (Legal Business Name): SHARRY LU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E CARSON PLAZA DR STE 224
CARSON CA
90746-7337
US

IV. Provider business mailing address

10355 SLUSHER DR
SANTA FE SPRINGS CA
90670-7353
US

V. Phone/Fax

Practice location:
  • Phone: 657-215-0887
  • Fax:
Mailing address:
  • Phone: 213-264-1290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW115142
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: