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NPI Code Detail

MEDICARE: MRS. SHARON BLEVINS

MEDICARE: MRS. SHARON BLEVINS
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
1101YM0800XMental Health Counselor51451 MFT INTERNCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15898OTHERCAMEDICAL ID NUMBER

General Provider Information

NPI Number : 1912018771
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARON BLEVINS
Provider Business Mailing Address
First Line : 1501 GERRY WAY
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3415
Country : US
Telephone Number : 916-786-8908
Fax Number :
Provider Business Practice Location Address
First Line : 6147 SUTTER AVE
Second Line :
City : CARMICHAEL
State : CA
Zip : 95608-2738
Country : US
Telephone Number : 916-971-7640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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