Healthcare Provider Details

I. General information

NPI: 1932330727
Provider Name (Legal Business Name): SHARON LANGTRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 03/11/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 37TH AVE
SAN MATEO CA
94403-4324
US

IV. Provider business mailing address

1950 ALAMEDA DE LAS PULGAS
SAN MATEO CA
94403-1222
US

V. Phone/Fax

Practice location:
  • Phone: 650-573-3900
  • Fax: 650-573-2193
Mailing address:
  • Phone: 650-573-3900
  • Fax: 650-573-2193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: