Healthcare Provider Details

I. General information

NPI: 1437502622
Provider Name (Legal Business Name): SHARON F FLYNN MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARON LEE FIELDS

II. Dates (important events)

Enumeration Date: 07/22/2016
Last Update Date: 12/31/2021
Certification Date: 12/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3468 MT DIABLO BLVD STE B200
LAFAYETTE CA
94549-7102
US

IV. Provider business mailing address

3468 MT DIABLO BLVD STE B201
LAFAYETTE CA
94549-3959
US

V. Phone/Fax

Practice location:
  • Phone: 510-621-7742
  • Fax:
Mailing address:
  • Phone: 510-621-7742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number123670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: