MEDICARE: MS. SHARON COLEMAN MARTIN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS19355	CA

General Provider Information

NPI Number	:	1164531885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON COLEMAN MARTIN LCSW

Provider Business Mailing Address
First Line	:	901 CAMPISI WAY STE 150
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-2365
Country	:	US
Telephone Number	:	408-982-6535
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 CAMPISI WAY STE 150
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-2365
Country	:	US
Telephone Number	:	408-982-6535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	02/04/2019

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