Healthcare Provider Details

I. General information

NPI: 1952343626
Provider Name (Legal Business Name): SHARON BJORNSON MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 MOUNTAIN BLVD SUITE 205
OAKLAND CA
94611-2827
US

IV. Provider business mailing address

2080 MOUNTAIN BLVD SUITE 205
OAKLAND CA
94611-2827
US

V. Phone/Fax

Practice location:
  • Phone: 510-339-7707
  • Fax: 510-451-0460
Mailing address:
  • Phone: 510-339-7707
  • Fax: 510-451-0460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC22758
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: