Healthcare Provider Details

I. General information

NPI: 1093856882
Provider Name (Legal Business Name): SHARON L HARPER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 CRESCENT PARK W APT 123
PLAYA VISTA CA
90094-2285
US

IV. Provider business mailing address

6565 CRESCENT PARK W APT 123
PLAYA VISTA CA
90094-2285
US

V. Phone/Fax

Practice location:
  • Phone: 310-902-6211
  • Fax:
Mailing address:
  • Phone: 310-902-6211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95000033
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: