Healthcare Provider Details

I. General information

NPI: 1962219311
Provider Name (Legal Business Name): SHARAY NICOLE ROBINSON ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 FOLSOM BLVD STE 208
SACRAMENTO CA
95826-2620
US

IV. Provider business mailing address

711 G ST
SACRAMENTO CA
95814-1212
US

V. Phone/Fax

Practice location:
  • Phone: 916-538-9915
  • Fax:
Mailing address:
  • Phone: 916-875-1055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW120423
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW120423
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: