Healthcare Provider Details

I. General information

NPI: 1164624375
Provider Name (Legal Business Name): SHARON LEE PICARD PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7827 GRISWOLD LOOP
NEW PORT RICHEY FL
34655-2735
US

IV. Provider business mailing address

7827 GRISWOLD LOOP
NEW PORT RICHEY FL
34655-2735
US

V. Phone/Fax

Practice location:
  • Phone: 808-346-8101
  • Fax:
Mailing address:
  • Phone: 808-346-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1409
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY60689616
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number3496
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number11429
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: