Provider Demographics
NPI:1043371750
Name:ARMSTRONG, SHARON S (PHD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:S
Other - Last Name:FAFF, JENKING, MANGUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3528 APPALOOSA WAY
Mailing Address - Street 2:
Mailing Address - City:ANGELS CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95222-9669
Mailing Address - Country:US
Mailing Address - Phone:209-754-3463
Mailing Address - Fax:
Practice Address - Street 1:23W ST CHARLES ST
Practice Address - Street 2:
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249
Practice Address - Country:US
Practice Address - Phone:209-754-3463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13447103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL134470Medicaid
CA0PL134479Medicare PIN
CA0PL134479Medicare PIN