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General NPI Number Information
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NPI Number | 1063005213
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Entity Type | Individual
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Provider Name | MANNYA RAJESH SHARMA LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1085 W BADILLO ST
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City | COVINA
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State | CA
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Zip | 91722-4112
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Country | US
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Telephone | 626-332-8138
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Fax | 626-332-0433
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Provider Business Mailing Address
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Address Line | 5400 POMONA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-1717
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Country | US
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Telephone | 323-837-2133
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Fax | 323-721-2437
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 121039
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License Number State | CA
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