Healthcare Provider Details

I. General information

NPI: 1134178692
Provider Name (Legal Business Name): SHARON GARRETT L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16055 VENTURA BLVD SUITE 828
ENCINO CA
91436-2601
US

IV. Provider business mailing address

16055 VENTURA BLVD SUITE 828
ENCINO CA
91436-2601
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-2520
  • Fax:
Mailing address:
  • Phone: 818-788-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL 8266
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberL8266
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: