Healthcare Provider Details

I. General information

NPI: 1790716082
Provider Name (Legal Business Name): SHARAINE LEE THOMPSON D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARAINE LEE KENNEDY DC

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 SHOREHAM PL STE 175
SAN DIEGO CA
92122-5925
US

IV. Provider business mailing address

5151 SHOREHAM PL STE 175
SAN DIEGO CA
92122-5925
US

V. Phone/Fax

Practice location:
  • Phone: 858-558-3111
  • Fax: 858-558-3641
Mailing address:
  • Phone: 858-558-3111
  • Fax: 858-558-3641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC25390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: