Provider Demographics
NPI:1104043074
Name:GROOVER, SHARON ANNE I (MFT)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ANNE
Last Name:GROOVER
Suffix:I
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:ANNE
Other - Last Name:KOBAYASHI
Other - Suffix:I
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:147 N WILLOW SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-4513
Mailing Address - Country:US
Mailing Address - Phone:714-289-8719
Mailing Address - Fax:
Practice Address - Street 1:16152 BEACH BLVD
Practice Address - Street 2:STE 170
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3806
Practice Address - Country:US
Practice Address - Phone:714-324-7698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC17844106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist