Healthcare Provider Details

I. General information

NPI: 1063926269
Provider Name (Legal Business Name): SHARON NAJMEH STOCK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS SHARON NAJMEH HARDWICK

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W 17TH ST
SANTA ANA CA
92706-2316
US

IV. Provider business mailing address

364 N SHATTUCK PL
ORANGE CA
92866-1231
US

V. Phone/Fax

Practice location:
  • Phone: 714-824-9017
  • Fax:
Mailing address:
  • Phone: 818-285-9312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number95105135
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number95105135
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number95105135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: