Provider Demographics
NPI:1073763512
Name:CRAIG, SHARON (LM, MMID)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LM, MMID
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:ECONOMIDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2872 ARLINGTON PL
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-1437
Mailing Address - Country:US
Mailing Address - Phone:510-812-4738
Mailing Address - Fax:
Practice Address - Street 1:2872 ARLINGTON PL
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-1437
Practice Address - Country:US
Practice Address - Phone:510-812-4738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-21
Last Update Date:2008-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife