Healthcare Provider Details

I. General information

NPI: 1154884724
Provider Name (Legal Business Name): SHARON PICKFORD DC, OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6820 LA TIJERA BLVD STE 208
LOS ANGELES CA
90045-1931
US

IV. Provider business mailing address

6820 LA TIJERA BLVD STE 208
LOS ANGELES CA
90045-1931
US

V. Phone/Fax

Practice location:
  • Phone: 323-306-6064
  • Fax: 888-281-7759
Mailing address:
  • Phone: 323-306-6064
  • Fax: 888-281-7759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number23349
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: