Healthcare Provider Details

I. General information

NPI: 1639686934
Provider Name (Legal Business Name): SHARLISA L BYRD LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2066 N CAPITOL AVE
SAN JOSE CA
95132-1015
US

IV. Provider business mailing address

322 GREENPARK WAY
SAN JOSE CA
95136-2126
US

V. Phone/Fax

Practice location:
  • Phone: 408-514-7059
  • Fax: 408-413-0482
Mailing address:
  • Phone: 408-514-7059
  • Fax: 408-413-0482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number124402
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT3033
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: