=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346890720
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RINA SHARFSTEIN PSYD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2019
-----------------------------------------------------
Last Update Date | 07/11/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1036 SIR FRANCIS DRAKE BLVD STE 12
-----------------------------------------------------
City | KENTFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94904-1471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-522-7415
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1036 SIR FRANCIS DRAKE BLVD STE 12
-----------------------------------------------------
City | KENTFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94904-1471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-522-7415
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL PSYCHOLOGIST
-----------------------------------------------------
Name | DR. RINA SHARFSTEIN
-----------------------------------------------------
Credential | PSYD
-----------------------------------------------------
Telephone | 415-522-7415
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------