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General NPI Number Information
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NPI Number | 1245528447
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Entity Type | Organization
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Legal Business Name | SHARON GERSTENZANG
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 10101 SLATER AVE STE 205
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4741
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Country | US
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Telephone | 714-964-3126
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Fax | 714-964-5784
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Provider Business Mailing Address
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Address Line | 10101 SLATER AVE STE 205
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4741
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Country | US
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Telephone | 714-964-3126
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Fax | 714-964-5784
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Authorized Official
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Title or Position | PSYCHOLOGIST, FOUNDER
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Name | DR. SHARON MARGOT-DREGNE GERSTENZANG
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Credential | PHD
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Telephone | 714-964-3126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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