Provider Demographics
NPI:1013381227
Name:SHARMA, PRATIBHA
Entity Type:Individual
Prefix:
First Name:PRATIBHA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 SPOONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-4307
Mailing Address - Country:US
Mailing Address - Phone:925-687-8229
Mailing Address - Fax:
Practice Address - Street 1:4414 SPOONWOOD CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-4307
Practice Address - Country:US
Practice Address - Phone:925-687-8229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-26
Last Update Date:2015-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst