Healthcare Provider Details

I. General information

NPI: 1760692685
Provider Name (Legal Business Name): SHARON ANN RILEY MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 RIVER RD
SALINAS CA
93908-9601
US

IV. Provider business mailing address

PO BOX 844
MOSS LANDING CA
95039-0844
US

V. Phone/Fax

Practice location:
  • Phone: 831-455-4767
  • Fax:
Mailing address:
  • Phone: 831-320-2397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 40017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: