Healthcare Provider Details

I. General information

NPI: 1073020731
Provider Name (Legal Business Name): SHARLETT BARNETT ROSE BS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARLETT B ROSE AMFT

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 JEFFERSON ST
OAKLAND CA
94612-1215
US

IV. Provider business mailing address

150 GRAND AVE STE 200
OAKLAND CA
94612-3726
US

V. Phone/Fax

Practice location:
  • Phone: 510-714-0996
  • Fax: 510-923-0894
Mailing address:
  • Phone: 510-923-1099
  • Fax: 510-923-0894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6315
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number153327
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number153327
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: