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NPI Code Detail

MEDICARE: SHARON DAVIS

MEDICARE:   SHARON  DAVIS
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
1106H00000XMarriage & Family Therapist85871CA

General Provider Information

NPI Number : 1811362668
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON DAVIS
Provider Business Mailing Address
First Line : 130 LINCOLN ST
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4733
Country : US
Telephone Number : 707-299-8596
Fax Number :
Provider Business Practice Location Address
First Line : 130 LINCOLN ST
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4733
Country : US
Telephone Number : 707-299-8596
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2015
Last Update Date : 12/04/2015

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Directions to “ SHARON DAVIS ” Practice Location

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