Healthcare Provider Details

I. General information

NPI: 1770166639
Provider Name (Legal Business Name): NISHTHA SHARMA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8910 CLAIREMONT MESA BLVD
SAN DIEGO CA
92123-1104
US

IV. Provider business mailing address

PO BOX 231084
SAN DIEGO CA
92193-1084
US

V. Phone/Fax

Practice location:
  • Phone: 858-514-5100
  • Fax:
Mailing address:
  • Phone: 623-565-2628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC19459
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: