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General NPI Number Information
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NPI Number | 1821538943
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Entity Type | Individual
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Provider Name | SHARON MIYAMURA
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Gender | Female
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1020 S ARROYO PKWY
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City | PASADENA
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State | CA
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Zip | 91105-3911
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Country | US
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Telephone | 626-403-2794
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Fax |
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Provider Business Mailing Address
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Address Line | 679 S NEW HAMPSHIRE AVE STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90005-1355
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Country | US
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Telephone |
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Fax |
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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 | LCSW104594
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License Number State | CA
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