MEDICARE: SHEERIN SHARON ASHRAFI

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	103K00000X	Behavior Analyst	1-18-34157	CA

General Provider Information

NPI Number	:	1548724826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEERIN SHARON ASHRAFI

Provider Business Mailing Address
First Line	:	211 N EASTMAN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90063-2309
Country	:	US
Telephone Number	:	213-880-9035
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 CORPORATE CENTER DR
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-7646
Country	:	US
Telephone Number	:	323-796-0353
Fax Number	:

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

Provider Enumeration Date	:	01/30/2019
Last Update Date	:	01/30/2019

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