Healthcare Provider Details

I. General information

NPI: 1831881580
Provider Name (Legal Business Name): SHARON CHANITA WIMBERLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 FLORIN RD STE 600
SACRAMENTO CA
95823-2527
US

IV. Provider business mailing address

4433 FLORIN RD STE 600
SACRAMENTO CA
95823-2527
US

V. Phone/Fax

Practice location:
  • Phone: 916-926-7259
  • Fax:
Mailing address:
  • Phone: 916-926-7259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: