Healthcare Provider Details

I. General information

NPI: 1801581707
Provider Name (Legal Business Name): SHARON DINICHOLAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11230 SORRENTO VALLEY RD STE 225
SAN DIEGO CA
92121-1338
US

IV. Provider business mailing address

11230 SORRENTO VALLEY RD STE 225
SAN DIEGO CA
92121-1338
US

V. Phone/Fax

Practice location:
  • Phone: 858-567-4246
  • Fax:
Mailing address:
  • Phone: 205-266-3978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95040668
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPR.0998559-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1169343
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: